Abstract: Objective To analyze the clinical manifestations and influencing factors of invasive fungal infection (IFI) in patients with chronic and acute liver failure (ACLF). Methods From January 2017 to January 2019, 136 patients with ACLF (male 107 and female 29, 51.9 ±7.7 years old) were reviewed. ACLF meets the diagnostic requirements of the guidelines for diagnosis and treatment of liver failure (2012 edition). IFI meets the diagnostic requirements of "guidelines for diagnosis and treatment of invasive fungal infections in critically ill patients (2007)". The measurement data are expressed as (x?±s) or [M (P₂₅ ~ P₇₅)], t-test or Kruskal-Wallis H test comparison; count data are expressed as (%), chi-square test comparison. Results The causes of ACLF included hepatitis B virus infection in 78 cases (57.3%), alcoholic factors in 11 cases (8.1%), drug factors in 28 cases (20.6%), autoimmune factors in 12 cases (8.8%) and other factors in 7 cases (5.1%). There were 40 cases of diabetes (29.4%), 46 cases of hemodialysis (33.8%), 61 cases of history of antimicrobial use (44.9%) and 54 cases of invasive treatment or operation (39.7%). There were 62 patients with IFI in ACLF group and 74 patients in non-IFI group. There were significant differences in diabetes, hemodialysis, history of antimicrobial use, invasive treatment or operation and death between the two groups. 70 patients with ACLF survived as the survival group, and 66 patients died as the survival group. There were significant differences in hemodialysis, invasive treatment or operation, MELD score and the number of IFI cases between the two groups. Conclusion The prognosis of ACLF patients with IFI is poor. Patients should pay attention to blood glucose control, rational use of antibiotics, reduce or avoid the number of invasive treatment or operation.

Key words: Acute-on-chronic liver failure, Invasive fungal infections, Diabetes, Hemodialysis