Risk factors of early-onset and late-onset pulmonary candidiasis related to mechanical ventilation and analysis of prognostic factors associated with mortality.

OBJECTIVE To investigate the difference in risk factors between early-onset infection and late-onset infection of invasive pulmonary candidiasis in patients who accepted mechanical ventilation,and analysis the prognostic factors associated with mortality.METHODS A retrospective case-control study was performed,including 114 cases of who have accepted mechanical ventilation more than 48 hours.The infected 50 cases were sorted to early-onset infection group and late-onset group,no-infected group as the control group,and univariate analysis(χ2-test)and multivariate logistic regression analysis perform were,and the prognostic factors associated with mortality were analyzed with univariate analysis(χ2-test).RESULTS The univariate analysis and multivariate logistic regression showed that the independent risk factors for early-onset invasive pulmonary candidiasis infection included changes in antibiotics more than 2-times(OR=5.828,P=0.001),cases with more than two kinds of diseases(OR=4.538,P=0.008),at the same time,eld(OR=5.684,P=0.000)and serum albumn less than 25 grams(OR=2.279,P=0.000)were the independent risk factors for late-onset infection.Prophylactic antifungal treatment(OR1=0.064,P1=0.004;OR2=0.561,P2=0.014)was a protective factor for both of them.The risk factors associated with prognosis included with more than two kinds of diseases(P=0.026),coma(P=0.001)and renal dysfunction(P=0.002).CONCLUSIONS The risk factors between early-onset infection and late-onset infection of invasive pulmonary candidiasis in patients who accepted mechanical ventilation.is different Finding these risk factors in time and starting the necessary and accurate treatment earlier are important for improving prognosis.