Clinical analysis of 47 cases of nosocomial pulmonary fungal infection in respiratory intensive care unit

Objective To analyze morbility,risk factors,etiology,treatment and outcome of nosocomial pulmonary fungal infections in respiratory intensive care unit(RICU).Methods Forty-seven respiratory RICU patients with nosocomial pulmonary fungal infections between July 2000 and June 2005 were retrospectively analyzed.Results All of the 47 cases were clinically diagnosed as probable nosocomial pulmonary fungal infections,with the morbidity of 10.8% significantly higher than general wards(1.8%,P0.005).Chronic obstructive pulmonary disease and bacterial pneumonia were the major underlying diseases of respiratory system with a percent of 38.30% and 36.17%,respectively.Forty-one patients(87.2%) had risk factors for fungal infections.Compared with general wards,the proportion of Aspergillosis was higher in RICU without significant difference(P0.1);the proportions of Candida glabrata and Candida tropicalis were higher too,but that of Candida krusei was relatively low.The effective rate of antifungal treatment was 79.1% and fluconazol was the most common used antifungal agents.The mortality of fungal infection in RICU was higher than that of general wards but without significant difference(P0.1).Conclusions The morbidity of nosocomial pulmonary fungal infection in respiratory RICU is higher than that in general wards.The proportions of infection caused by Aspergilli and some Candida resistant to fluconazol is relatively high.Early and effective treatment is needed in these patients considering the poor prognosis.