Analysis of the Situation and Influencing Factors of Fungal Detection in Adult Patients with Severe Diseases in Tibet Region

Objective To explore the situation of fungal detection in adult patients with severe diseases in Tibet region, and further analyze the influencing factors of fungal detection. Methods All patients admitted to the Department of Critical Care Medicine Tibet Autonomous Region People's Hospital...

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Autores principales:	FU Jianlei, SU Longxiang, PAN Wenjun, LIN Guoying, CHAI Wenzhao, WANG Xiaoting
Formato:	article
Lenguaje:	ZH
Publicado:	Editorial Office of Medical Journal of Peking Union Medical College Hospital 2021
Materias:	tibet region fungus patients with severe diseases influencing factor Medicine R
Acceso en línea:	https://doaj.org/article/1608a057b75b4b51a3a71374c0be571b
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spelling	oai:doaj.org-article:1608a057b75b4b51a3a71374c0be571b2021-12-01T01:40:16ZAnalysis of the Situation and Influencing Factors of Fungal Detection in Adult Patients with Severe Diseases in Tibet Region1674-908110.12290/xhyxzz.2021-0531https://doaj.org/article/1608a057b75b4b51a3a71374c0be571b2021-10-01T00:00:00Zhttps://xhyxzz.pumch.cn/en/article/doi/10.12290/xhyxzz.2021-0531https://doaj.org/toc/1674-9081Objective To explore the situation of fungal detection in adult patients with severe diseases in Tibet region, and further analyze the influencing factors of fungal detection. Methods All patients admitted to the Department of Critical Care Medicine Tibet Autonomous Region People's Hospital from January 1, 2018 to December 31, 2019 were retrospectively analyzed. According to the results of fungal detection, the patients were then divided into the positive group and the negative group. The distribution of fungal strains detected and clinical data of the two groups were collected by the electronic medical record system. Multivariate Logistic regression was used to analyze the influencing factors of fungal detection. Results A total of 755 severe patients (4917 specimens were submitted) were enrolled, including 142 patients with positive fungal detection and 613 patients with negative fungal detection.Of which, 192 fungal strains were detected, including 183(95.3%) Candida strains, 7(3.7%) Aspergillus strains and 2(1.0%) other fungi strains. Among Candida genus, there were 164 strains (89.6%) of Candida albicans, 9 strains (4.9%) of Candida glabrata, 7 strains (3.8%) of Candida parapsilosis, 2 strains (1.1%) of Candida krusei, and 1 strain (0.6%) of Candida tropicalis. Among Aspergillus, there were 3 strains (42.8%) of Aspergillus fumigatus, 2 strains (28.6%) of Aspergillus niger, and 2 strains (28.6%) of Aspergillus flavus. Multivariate Logistic regression analysis showed that, high sequential organ failure assessment score (OR=1.402, 95% CI: 1.277-1.538, P < 0.001), severe digestive diseases (OR=2.671, 95% CI: 1.465-4.872, P=0.001), the duration of tracheal intubation ≥48 h(OR=2.661, 95% CI: 1.611-4.397, P=0.000), the use of carbapenemes ≥24 h (OR=2.825, 95% CI: 1.522-5.245, P=0.001), the use of cephalosporins plus beta lactamase inhibitor ≥24 h (OR=2.678, 95% CI: 1.679-4.272, P=0.000), and the long ICU stay (OR=1.043, 95% CI: 1.011-1.076, P=0.008) were independent risk factors for fungal detection in adult patients with severe diseases. High altitude of residence (OR=0.999, 95% CI: 0.999-1.000, P=0.040) and the high hemoglobin level (OR=0.994, 95% CI: 0.988-0.999, P=0.020) were protective factors. Conclusions Positive fungal detection in adult patients with severe diseases in the Tibet area is not uncommon, and Candida albicans is the main strain detected. The factors affecting the detection of fungi involve many aspects. Corresponding preventive measures should be taken according to the characteristics of Tibet.FU JianleiSU LongxiangPAN WenjunLIN GuoyingCHAI WenzhaoWANG XiaotingEditorial Office of Medical Journal of Peking Union Medical College Hospitalarticletibet regionfunguspatients with severe diseasesinfluencing factorMedicineRZHXiehe Yixue Zazhi, Vol 12, Iss 5, Pp 791-797 (2021)
institution	DOAJ
collection	DOAJ
language	ZH
topic	tibet region fungus patients with severe diseases influencing factor Medicine R
spellingShingle	tibet region fungus patients with severe diseases influencing factor Medicine R FU Jianlei SU Longxiang PAN Wenjun LIN Guoying CHAI Wenzhao WANG Xiaoting Analysis of the Situation and Influencing Factors of Fungal Detection in Adult Patients with Severe Diseases in Tibet Region
description	Objective To explore the situation of fungal detection in adult patients with severe diseases in Tibet region, and further analyze the influencing factors of fungal detection. Methods All patients admitted to the Department of Critical Care Medicine Tibet Autonomous Region People's Hospital from January 1, 2018 to December 31, 2019 were retrospectively analyzed. According to the results of fungal detection, the patients were then divided into the positive group and the negative group. The distribution of fungal strains detected and clinical data of the two groups were collected by the electronic medical record system. Multivariate Logistic regression was used to analyze the influencing factors of fungal detection. Results A total of 755 severe patients (4917 specimens were submitted) were enrolled, including 142 patients with positive fungal detection and 613 patients with negative fungal detection.Of which, 192 fungal strains were detected, including 183(95.3%) Candida strains, 7(3.7%) Aspergillus strains and 2(1.0%) other fungi strains. Among Candida genus, there were 164 strains (89.6%) of Candida albicans, 9 strains (4.9%) of Candida glabrata, 7 strains (3.8%) of Candida parapsilosis, 2 strains (1.1%) of Candida krusei, and 1 strain (0.6%) of Candida tropicalis. Among Aspergillus, there were 3 strains (42.8%) of Aspergillus fumigatus, 2 strains (28.6%) of Aspergillus niger, and 2 strains (28.6%) of Aspergillus flavus. Multivariate Logistic regression analysis showed that, high sequential organ failure assessment score (OR=1.402, 95% CI: 1.277-1.538, P < 0.001), severe digestive diseases (OR=2.671, 95% CI: 1.465-4.872, P=0.001), the duration of tracheal intubation ≥48 h(OR=2.661, 95% CI: 1.611-4.397, P=0.000), the use of carbapenemes ≥24 h (OR=2.825, 95% CI: 1.522-5.245, P=0.001), the use of cephalosporins plus beta lactamase inhibitor ≥24 h (OR=2.678, 95% CI: 1.679-4.272, P=0.000), and the long ICU stay (OR=1.043, 95% CI: 1.011-1.076, P=0.008) were independent risk factors for fungal detection in adult patients with severe diseases. High altitude of residence (OR=0.999, 95% CI: 0.999-1.000, P=0.040) and the high hemoglobin level (OR=0.994, 95% CI: 0.988-0.999, P=0.020) were protective factors. Conclusions Positive fungal detection in adult patients with severe diseases in the Tibet area is not uncommon, and Candida albicans is the main strain detected. The factors affecting the detection of fungi involve many aspects. Corresponding preventive measures should be taken according to the characteristics of Tibet.
format	article
author	FU Jianlei SU Longxiang PAN Wenjun LIN Guoying CHAI Wenzhao WANG Xiaoting
author_facet	FU Jianlei SU Longxiang PAN Wenjun LIN Guoying CHAI Wenzhao WANG Xiaoting
author_sort	FU Jianlei
title	Analysis of the Situation and Influencing Factors of Fungal Detection in Adult Patients with Severe Diseases in Tibet Region
title_short	Analysis of the Situation and Influencing Factors of Fungal Detection in Adult Patients with Severe Diseases in Tibet Region
title_full	Analysis of the Situation and Influencing Factors of Fungal Detection in Adult Patients with Severe Diseases in Tibet Region
title_fullStr	Analysis of the Situation and Influencing Factors of Fungal Detection in Adult Patients with Severe Diseases in Tibet Region
title_full_unstemmed	Analysis of the Situation and Influencing Factors of Fungal Detection in Adult Patients with Severe Diseases in Tibet Region
title_sort	analysis of the situation and influencing factors of fungal detection in adult patients with severe diseases in tibet region
publisher	Editorial Office of Medical Journal of Peking Union Medical College Hospital
publishDate	2021
url	https://doaj.org/article/1608a057b75b4b51a3a71374c0be571b
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Analysis of the Situation and Influencing Factors of Fungal Detection in Adult Patients with Severe Diseases in Tibet Region

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