Objective To investigate the fungal species distribution, liability factors, therapy and prevention of fungal septicemia.Methods A time-matched case-control study was conducted in 30 patients fromApril 2011 to November 2012 with fungal septicemia. Results Of the pathogens in 30 cases with fungal septicemia, 43.3% was Candida albicans, 23.3% was Candida tropicalis, and 10% was Candida parapsilosis. All 30 cases with fungal septicemia were hospital acquired. Malignant hematological system disease( 33.3% ) , COPD( 23.3% ) , and diabetes ( 20.0% ) were the main predisposing diseases. Broadspectrumantibiotic use( 86.7% ) , endovascular prosthesis( 60.0% ) , parenteral alimentation( 53.3% ) were the major risk factors. All 30 cases received systemic anti-fugal therapy. The efficacy rate of amphotericin B therapy was higher than that of fluconazol ( P =0.002) and voriconazole( P = 0.006) . 13 cases( 43.3% ) were cured or significantly improved, and 17 cases( 56.7% ) were dead. Conclusions The most frequently fungi was Candida albicans in fungal septicemia. Malignant hematological system disease and COPD were main predisposing diseases. Broad-spectrumantibiotic use and parenteral alimentation were independent risk factors. Anti-fugal therapy with amphotericin B can achieve better prognosis. Early diagnosis, controlling risk factors, and earlier empirical antifungal therapy are keys to reduce mortality of fungal septicemia.
Objective To investigate the differences in bacteria distribution and drug resistance of pathogens in patients with lower respiratory tract infection between respiratory general wards and respiratory intensive care unit ( RICU) .Methods All the clinical isolates fromsputumor secretion of lower respiratory tract from2007. 1-2010. 10 were analyzed retrospectively. Antibiotic susceptibility was tested by Kirby-Bauer method. Results The total number of isolated strains was 3202. Among 1254 strains isolated from respiratory general wards, Gram-positive bacteria accounted for 2. 63% , Gram-positive bacteria accounted for 42. 42% , and fungi accounted for 54. 95% . Streptococcus pneumoniae ranked first place among Gram-positive bacteria, accounting for 51. 52% . Haemophilus parainfluenzae bacillus ranked first place among Gramnegative bacteria, accounting for 21. 99% . Both were sensitive to the most commonly used antibiotics. Among 1948 strains isolated from RICU ward, Gram-positive bacteria accounted for 4. 52% , Gram-positive bacteria accounted for 37.73% , and fungi accounted for 57. 75% . Staphylococcus aureus ranked first place among Gram-positive bacteria, accounting for 52. 27% . Acinetobacter baumannii ranked first place in Gramnegative bacteria, accounting for 27. 35% . Both were resistant to most commonly used antibiotics. Pseudomonas aeruginosa had a higher rate of infection both in the general wards and RICU, and was resistant to most commonly used antibiotics.Conclusions In lower respiratory tract infection of respiratory general ward, Gram-positive bacteria with Streptococcus pneumoniae mainly and Gram-negative bacteria with Haemophilus parainfluenzae mainly are both sensitive to the most commonly used antibiotics. While in the RICU ward, Gram-positive bacteria infections with Staphylococcus aureus mainly and Gram-negative bacteria infections with Acinetobacter baumannii mainly are both resistant to most commonly used antibiotics.