中文摘要：

目的了解综合医院住院患者深部真菌感染状况,为临床防治深部真菌感染提供依据.方法对昆明医科大学第一附属医院2011年2月至2011年5月住院病历进行回顾性分析,依据深部真菌感染诊断标准确定深部真菌感染病例并采集分析相关数据.结果 （1）总共分析22 185份病例中,深部真菌感染病例139例,占总病例数0.63%,其中达到确诊标准占12例;临床诊断52例;拟诊75例;（2）深部真菌感染主要发生在60岁以上患者,占所有诊断深部真菌感染病例的58.27%;（3）呼吸科为发生院内深部真菌感染最多的科室,占36.69%,其次为血液科和重症监护室,分别占30.22%和11.51%;（4）深部真菌感染的部位主要为肺部（69.06%）和口腔（14.39%）.送检标本中痰液的真菌检查阳性率最高（占62.69%）,白假丝酵母菌仍是昆明医科大学第一附属医院住院患者深部真菌感染的主要致病菌（占64.77%）;（5）院内深部真菌感染主要危险因素为使用广谱抗生素（69.78%）、系统使用糖皮质激素（51.80%）和免疫抑制剂或化疗药物（30.22%）;（6）临床使用抗真菌药物的种类主要为三唑类,以氟康唑（60.18%）和伏立康唑（46.61%）为主,抗真菌治疗后多数患者预后良好,76.47%患者治愈和好转.结论 （1）深部真菌感染的诊断级别多为拟诊,其次为临床诊断,确诊率较低,提示临床应重视深部真菌感染病原学的检查;（2）深部真菌感染多发的科室为呼吸科、血液科和重症监护室,故上述科室应重视真菌感染的防治;（3）长期应用抗生素、糖皮质激素及免疫抑制剂与化疗药物患者以及大于60岁老年患者易发生深部真菌感染,是重点防护人群.

英文摘要：

Objecfive To study the epidemiology of deep fungal infection of inpatients in general hospital,and to provide reference for the prevention and cure of deep fungus infection. Methods A retrospective analysis was carried out on hospitalized cases of our hospital from February 1, 2011 to May 31, 2011. According to the diagnostic standard of deep fungal infection, then we collected and analyzed the data. Results（1） In 22185 cases inpatients of general hospital,there were 139 cases of deep fungal infection, accounting for 0.63% of the total number. There were 12 cases of confirmed diagnosis, 52 cases of clinical diagnosis and 75 cases of suspecting diagnosis. 2. Deep fungal infection occurred mainly in patients over 60 years old（about 58.27% of 139 cases）. 3.The most deep fungal infected cases were detributed to the Department of Respiratory, Department of Hematology and ICU. 4. The starting position of deep fungal infection are lungs（69.06%） and mouth（14.39%）. Fungus inspection for sputum specimens were most positive（62.69）. Candida albicans（64.77%） was still the main pathogen of deep fungal infection in our hospital. 5. The major risk factors of deep fungus infection in hospitalincluded using of broad- spectrum antibiotics（69.78%）, system glucocorticoid（51.80%）,immunosuppressive agents and chemotherapy drugs（30.22%）. Conclusions（1） The most deep fungal infected cases are suspecting diagnosis,followed by clinical diagnosis. The rate of confirmed cases is lower than the others. Pathogenic examination of deep fungal infection should be applied more often.（2） Most deep fungal infection cases are in the department of respiratory, the department of hematology and intensive care unit. These departments should pay more attention to prevention and treatment of fungal infection.（3） Long- term using of antibiotics,glucocorticoid, immunosuppressants,chemotherapy drugs and older age are the risk factors of deep fungal infection.