[Retrospective analysis of invasive fungal infection in surgical intensive care unit].
OBJECTIVE
To conduct a retrospective analysis of the invasive fungal infection (IFI) in surgical intensive care unit (SICU).


METHODS
The IFI data of the patients who were admitted in SICU during January 2003 to December 2008 was retrospectively analyzed. A total of 3743 patients were admitted into SICU. Among them, 271 patient's SICU duration was more than 48 hours, who had fungi examination.


RESULTS
Seventy-five patients were diagnosed IFI, the morbidity was 2.00% (75/3743), the incidence of fungemia was 0.27% (10/3743), the mortality of IFI patients was 49.33% (37/75). The morbidity rate of each year was almost the same. The mortality of 2007 and 2008 was higher than before (both P < 0.05). Thirty-four of all the 75 IFI patients got urinary tract infected, 37 got fungal pneumonia, 10 got fungemia, 1 got catheter-related fungal infection, 2 got fungal infection in abdomen, 2 got biliary tract infected. Eighty-six fungi strains which caused fungal infection were spotted. Candida albicans was the most common isolate (46.51%). Other isolates were Candida glabrata (22.09%), Candida tropicalis (13.95%), Candida parapsilosis (8.14%), Candida krusei (3.49%), Trichosporon (4.65%), Aspergillus (1.16%). Assist ventilation, combination of bacterial infection, treatment by broad spectrum antibiotics or more than three kinds of antibiotics were the most important risk factors of IFI in SICU. Prophylactic antifungal treatment may be useful.


CONCLUSIONS
The morbidity of IFI in our SICU was comparatively low, and the same of the incidence of fungemia. The mortality of IFI patients was markedly high. The main sites of infection were lung and urinary tract, and the pathogenic fungi strains were mostly Candidas. Assist ventilation, combination of bacterial infection, broad spectrum antibiotics treatment were the most important risk factors of IFI in SICU.
Li
Shu
S
Intensive Care Unit, Peking University People's Hospital, Beijing 100044, China. ls_lancet@yahoo.com.cn
An
You-Zhong
YZ
D003428:Cross Infection / Q000453:epidemiology*; D016469:Fungemia / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors