慢性肾病患者并发侵袭性真菌感染的流行病学特征及危险因素

Epidemiological characteristics and risk factors for invasive fungal infections in patients with chronic nephrosis

  • 摘要: 目的 探讨慢性肾病患者并发侵袭性真菌感染(IFI)的流行病学特征及危险因素。方法 选取2021年1月-2024年12月空军军医大学第一附属医院肾内科收治的慢性肾病患者345例为研究对象,统计所有患者IFI发生情况,分析慢性肾病患者并发IFI的流行病学特征及其危险因素。结果 345例慢性肾病患者中130例发生IFI,发生率为37.68%,其中年龄51~60岁患者的占比较高,女性患者占比较高; 分离的真菌排名前三位的依次为白色念珠菌、光滑念珠菌、热带念珠菌,分别占比53.08%、13.85%、11.54%; 感染部位排名前三的依次为呼吸系统、泌尿系统、血液系统,分别占比48.46%、26.92%、14.62%。多因素logistics回归分析发现,合并糖尿病、侵入性操作、使用抗菌药物、年龄大均是慢性肾病患者并发IFI的危险因素(P<0.05)。结论 女性、51~60岁慢性肾病患者并发IFI的风险高,常见感染部位为呼吸系统,真菌以白色念珠菌最为常见,合并糖尿病、侵入性操作、使用抗菌药物、年龄大与慢性肾病患者并发IFI有关。

     

    Abstract: OBJECTIVE To explore the epidemiological characteristics and risk factors for invasive fungal infections (IFI) in patients with chronic nephrosis. METHODS A total of 345 patients with chronic nephrosis who were treated in nephrology department of First Affiliated Hospital of PLA Air Force Military Medical University from Jan. 2021 to Dec. 2024 were recruited as the research subjects, the incidence of IFI among all the patients was statistically analyzed. The epidemiological characteristics and risk factors for the IFI in the patients with chronic nephrosis were analyzed. RESULTS Among the 345 patients with chronic nephrosis, 130 had IFI, with the incidence 37.68%; the proportion of the patients aged between 51 and 60 years old was high, and the female patients were dominant. Candida albicans, Candida glabrata and Candida tropicalis ranked the top 3 species of fungi, accounting for 53.08%, 13.85% and 11.54%, respectively. Respiratory system, urinary system and blood system ranked the top 3 infection sites, accounting for 48.46%, 26.92% and 14.62%, respectively. Multivariate logistic regression analysis showed that complication with diabetes mellitus, invasive operation, use of antibiotics and old age were the risk factors for the IFI in patients with chronic nephrosis(P<0.05). CONCLUSIONS The female aged between 51 and 60 years old are at high risk of IFI. The respiratory system is the common infection site. C. albicans is the predominant species of fungi. The complication with IFI is associated with diabetes mellitus, invasive operation, use of antibiotics and old age.

     

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