抗菌药物继发真菌感染46例临床调查与分析

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目的 :提醒医务人员在使用抗菌药物抗感染过程中应严格遵循抗菌药物的使用原则 ,合理选择与应用。方法 :以 1998年出院 (包括死亡 )患者为对象 ,回顾性调查抗菌药物继发真菌感染的情况。结果 :继发真菌感染者共计 72例 ,其中抗菌药物继发者 46例。多发于 6 0岁以上的老年患者 (5 0 % ) ;出现感染的时间多在用药后 3周之内 (5 2 .2 % ) ;好发部位为肠道、呼吸道和泌尿道。 2种以上抗菌药物联用继发感染的机率高 ,共 5 2例次 ,占77.6 %。仅 1种药物继发真菌感染的 12例患者中 ,第三代头孢菌素 10例 ,其中 6例为头孢曲松。就 46例患者使用的抗菌药物而言 ,仍然是第三代头孢菌素使用率最高 (48例次 )。结论 :抗菌药物尤其是第三代头孢菌素的滥用是继发真菌感染的重要因素 ,提高合理用药水平是减少院内二重感染的关键。 Purpose: To remind medical staff to strictly follow the principles of use of antibacterial drugs in the anti-infective use of antibiotics, and make reasonable choices and applications. Methods : A retrospective survey of secondary fungal infections of antibacterial agents was conducted on patients discharged from hospitals (including deaths) in 1998. Results: A total of 72 cases were secondary to fungal infections, including 46 secondary antibiotics. Occurred in elderly patients over 60 years of age (50%); the time of infection was more than 3 weeks after drug administration (5.2%); the predilection site was intestinal, respiratory and urinary tract. More than two kinds of antibiotics combined with secondary infections have a high probability of 52 cases, accounting for 77.6 %. Of the 12 patients with only one drug secondary fungal infection, 10 were the third generation cephalosporins, of which 6 were ceftriaxone. For the 46 antibacterial drugs used, the third-generation cephalosporins were still used the most (48 times). Conclusion: The abuse of antibiotics, especially the third generation cephalosporins, is an important factor in the secondary fungal infection. Increasing the level of rational drug use is the key to reducing the secondary infection in the hospital.
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