Critically ill patients in the digestive emergency department developed a nosocomial fungal infection clinical features and influencing factors

YANG Miao; CHEN Yan-zi; GUO Lei; LU Wei

doi:10.16048/j.issn.2095-5561.2024.04.09

Abstract：Objective To analyze the clinical features and influencing factors of nosocomial fungal infection in critically ill patients in digestive emergency department.Methods A total of 623 critically ill patients admitted to the Emergency Department of Gastroenterology in the First Affiliated Hospital of Air Force Medical University from March 2019 to March 2024 were selected as the study objects.The detection of fungal infection and clinical characteristics of patients were recorded,and the influencing factors of nosocomial fungal infection in critically ill patients in the department of digestive emergency were analyzed by Logistic regression.The regression prediction model was constructed according to the influencing factors,and the predictive value and consistency of the prediction model were evaluated by receiver operating characteristic(ROC)curve and H-L test.Results Among the 623 patients,51(8.19%)had nosocomial fungal infection(fungal infection group)and 572(91.81%)had no nosocomial fungal infection(no fungal infection group).Abdominal cavity infection was the most common infection site.In the fungal infection group,58 fungal strains were isolated,mainly Candida albicans.The factors influencing nosocomial fungal infection were diabetes,invasive procedure,combination of antibiotics,acute physiological and chronic health Ⅱ scores,C-reactive protein to albumin ratio(P＜0.05).A regression prediction model for nosocomial fungal infection in critically ill patients in the department of Digestive emergency was established according to the influencing factors.The area under ROC curve of this model for predicting nosocomial fungal infection was 0.878(95%confidence interval 0.821-0.935,P＜0.05),the sensitivity was 76.47%,and the specificity was 88.64%.The predicted model is in good agreement with the actual observation results.Conclusion Candida albicans is the most common form of nosocomial fungal infection in critically ill patients in the department of digestive emergency department,and it mostly occurs in the abdominal cavity.Diabetes mellitus,invasive procedures,combination of antibiotics,acute physiological and chronic healthⅡscores,and the ratio of C-reactive protein to albumin are the influencing factors of nosocomial fungal infection in critically ill patients in the department of digestive emergency department.The regression prediction model based on the above factors has high application value in predicting concurrent nosocomial fungal infection.