激素治疗大疱性疾病引起真菌感染回顾性分析

目的研究糖皮质激素治疗大疱性疾病患者发生医院真菌感染的病原菌分类、危险因素和防治对策。方法收集67例大疱性类天疱疮和38例天疱疮患者糖皮质激素治疗的临床资料,计算医院真菌感染率,分析相关危险因素。结果大疱性疾病患者糖皮质激素治疗出现医院真菌感染率达32.38%,口腔真菌感染率为27.61%,肺部真菌感染率为13.33%,主要病原菌分别为白念珠菌(69.77%),热带念珠菌(11.63%)和近平滑念珠菌(6.98%)。糖皮质激素剂量、免疫抑制剂、抗生素、住院日及糖尿病病史明显增加真菌感染危险,其中免疫抑制剂、抗生素和糖尿病病史为独立危险因素。结论糖皮质激素治疗大疱性疾病患者院内真菌感染发生率高,免疫抑制剂、抗生素和糖尿病病史是其主要危险因素。

The retrospective analysis of hospital fungal infection in Bullous disease patients treated with corticosteroids

Objective To investigate the risk factors, the pathogen classification,clinical characteristics and prevention counter- measures of hospital fungal infection in Bullous disease patients treated with eorticosteroids. Methods Sixty-seven patients with bul- lous pemphigoid and 38 patients with pemphigus treated with glueocorticoid were enrolled in this study. Their clinical data were col- lected to calculate the rate of hospital fungal infection and analysize its related risk factors. Results The rate of hospital fungal infec- tion was 32.38% in Bullous disease patients treated with corticosteroids. The rates of oral and pulmonary fungal infections were 27. 61% and 13.33%, and the main pathogens included C. albicans （69.77%）, C. tropical （ 11.63% ） and C. parapsilosis （6.98%）. The fungal infections were obviously associated with corticosteroids doses, inmunoinhibitors, antibiotics and the history of diabetes, and immune inhibitors, antibiotics. History of diabetes were considered as the independent risk factors. Conclusion A high inci- dence of fungal infection was found in Bullous disease patients treated with corticosteroids. The inmunoinhibitors, antibiotics and his- tory of diabetes were the main risk factors.