摘要
目的探讨慢性阻塞性肺疾病(COPD)患者急性加重期继发肺部真菌感染菌群分布及相关危险因素,为感染预防提供参考依据。方法对2011年1月-2013年3月收治的314例COPD急性加重期患者继发肺部真菌感染进行回顾性分析,分析患者的菌群分布及感染危险因素。结果 314例患者发生肺部真菌感染76例,感染率为24.2%;检出白色假丝酵母菌46株占60.5%、光滑假丝酵母菌8株占10.5%、热带假丝酵母菌8株占10.5%、酵母样真菌6株占7.9%、克柔假丝酵母菌3株占3.9%、曲霉菌属5株占6.6%;经单因素logistic回归分析合并糖尿病、机械通气、血清白蛋白<35g/L,Ⅱ型呼吸衰竭、长期使用糖皮质激素、长期应用广谱抗菌药物6个变量与继发真菌感染相关(P<0.05);经多因素logistic回归分析,合并糖尿病、机械通气、长期使用糖皮质激素、长期应用广谱抗菌药物是COPD急性加重期继发肺部真菌感染的独立危险因素(P<0.05)。结论 COPD急性加重期肺部真菌感染发病率较高,应采取预防控制措施,以降低感染率。
Abstract： OBJECTIVE To investigate the distribution of fungal flora causing secondary pulmonary fungal infections in patients with acute exacerbation of chronic obstructive pulmonary disease （COPD） and explore related risk factors so as to provide guidance for prevention infections. METHODS A total of 314 acuter exacerbation of COPD patients complicated with secondary pulmonary fungal infections, who were treated in the hospital from Jan 2011 to Mar 2013, were retrospectively analyzed, then the distribution of flora and the risk factors for infections were analyzed. RESULTS The pulmonary fungal infections occurred in 76 of 314 patients with the infection rates of 24.2%. Of the isolated fungi, there were 46 （60.5%） strains of Candida albicans, 8 （10.5%） strains of Candida glabrata, 8 （10.5 %） strains of Candida tropicalis, 6 （7.9 %） strains of yeast-like fungi, 3 （3.9 %） strains of Candida krusei, and 5 （6.6%） strains of Aspergillus. The univariate logistic regression analysis showed that the complication of diabetic mellitus, mechanical ventilation, serum albumin level less than 35 g/L, type Ⅱ respiratory failure, long-term use of glucocorticoids, and long-term use of broad spectrum antibiotics were associated with the secondary fungal infections （P〈0.05）; the multivariate logistic regression analysis showed that the complication of diabetic mellitus, mechanical ventilation, long-term use of glucocorticoids, and long-term use of broad spectrum antibiotics were the independent risk factors for the secondary pulmonary fungal infections in the patients with acute exacerbation of COPD （P〈0.05）. CONCLUSION The incidence of pulmonary fungal infections is high in the patients with acute exacerbation of COPD; it is necessary to take prevention measures so as to reduce the infeetion rate.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2014年第17期4245-4247,共3页
Chinese Journal of Nosocomiology
基金
浙江省重大科技专项基金资助项目(2006C13014)
关键词
慢性阻塞性肺疾病
真菌感染
危险因素
菌群分布
Chronic obstructive pulmonary disease
Fungal infection
Risk factor
Flora distribution
