酵母，尤其是假丝酵母（又称念珠菌）导致的血流感染逐年上升，且病死率高。本研究回顾性分析瑞金医院2008年1月~2012年12月医院内获得性酵母菌血症患者的临床资料，分析其发生率、菌种分布、28 d病死率及抗真菌治疗对预后的影响。结果显示，酵母菌血症发生率为0.34/1 000入院患者。28 d医院内病死率达27.1%。129例血流感染患者中，白念珠菌血症45例(34.9%)，非白念珠菌血症84例(65.1%)，其中近平滑念珠菌占18.6%、热带念珠菌占14.0%、光滑念珠菌占7.0%、季也蒙念珠菌占5.4%、清酒念珠菌占4.7%。101例患者(78.3%)行经验性抗真菌治疗，其中90例(69.8%)的经验性抗真菌治疗合适；28例(21.7%)未接受任何抗真菌治疗。发病5 d内接受合适经验性抗真菌治疗患者的病死率(20.0%)显著低于未接受合适治疗患者(43.6%)。多因素Cox回归分析显示，年龄(HR=1.036，P=0.005)、粒细胞缺乏(HR=15.497，P<0.001)及合适的抗真菌治疗与28 d病死率有关(HR=0.352，P=0.002)。因此，早期诊断并进行及时适当的治疗是减少酵母菌血症病死率的有效方法。

Yeasts, especially Candida, are important pathogens causing bloodstream infections (BSIs), responsible for significant mortality and morbidity among hospitalized patients. The present paper aims to report the current epidemiology of yeast BSI in Ruijin Hospital from January 2008 to December 2012, and to estimate the impact of appropriate antifungal therapy on the outcomes. The incidence of nosocomial yeast BSI was 0.34 episodes /1 000 hospitalized patients, and the overall crude 28-day mortality rate was 27.1%. The proportion of yeast BSI caused by non- Candida albicans (C. albicans)(65.1%) including C. parapsilosis (18.6%), C. tropicalis (14.0%), C. glabrata (7.0%), C. guilliermondii (5.4%) and C. sake (4.7%) was higher than that of C. albicans (34.9%). Among 129 cases of yeast BSI, 78.3% (101 cases) received empiric antifungal therapy of which only 69.8% (90 cases) were considered appropriate, while 21.7% (28 cases) did not receive any antifungal agent. The mortality was significantly lower in those who received appropriate empiric antifungal therapy compared with those who received inappropriate empiric antifungal therapy (20.0% vs. 43.6%, P=0.006) within 5 d of the onset. The age (HR=1.036, P=0.005) and neutropenia <500/mm3 (HR=15.497, P<0.001) were independent risk factors for 28-day mortality, while appropriate empiric antifungal therapy (HR=0.325, P=0.002) was protective factor. Appropriate empiric antifungal therapy influenced the short-term survival.