摘要
目的探讨肺结核继发真菌感染的危险因素,并分析药敏情况,为预防和治疗提供参考。方法对医院收治的186例肺结核患者行常规真菌检测,根据真菌感染分为继发真菌感染组67例和非真菌感染组119例,分析患者的临床特点、真菌分离鉴定及耐药性。结果继发真菌感染组患者复治、年龄>50岁、长期应用激素、抗菌药物及合并糖尿病患者例数显著高于非真菌感染组(P<0.05);肺结核继发真菌感染以假丝酵母菌居多,共59株占88.06%;白色假丝酵母菌的耐药率较低,仅6株对氟胞嘧啶耐药;光滑假丝酵母菌除对伊曲康唑无耐药,对其他4种药物均产生耐药性;热带假丝酵母菌对两性霉素B和氟康唑产生耐药性,其耐药率为28.56%。结论肺结核继发真菌感染的发生率较高,老年患者、长期应用激素、抗菌药物及合并糖尿病是其危险因素,入院时应行常规药敏检测,早期治疗,以免延误治疗时机。
OBJECTIVE To explore the risk factors of secondary fungal infections in the patients with pulmonary tuberculosis and analyze the result of drug susceptibility testing so as to guide the clinical prevention and treatment. METHODS The fungal detection was performed for 186 cases of patients with pulmonary tuberculosis, the patients were divided into the fungal infection group （n=67） and the non-fungal infection group （n=119）, and the clinical features of the patients, isolation and identification of the fungi, and drug resistance were analyzed. RESULTS The cases of retreatment, the cases aged more than 50 years, the cases with long-term use of antibiotics and glucocorticoid, and the cases with gestational diabetes were significantly higher in the fungal infection group than in the non-fungal infection group （P〈0.05）. Candida were the predominant pathogens cau-sing the secondary fungal infections in the pulmonary tuberculosis patients, accounting for 88. 06%（59 strains ） ; the drug resistance rate of Candida albicans was low , there were only 6 strains of C. albicans resistance to flucy-tosine; C. glabrata strains were resistant to all the 5 antibiotics except itraconazole; C. tropicalis strains were re-sistant to amphotericin B and fluconazole with the drug resistance rate of 28. 56%. CONCLUSION The incidence rate of secondary fungal infections is high in the pulmonary tuberculosis patients. The senile patients, long-term use of antibiotics and glucocorticoid, and gestational diabetes are the risk factors for the secondary fungal infec-tions in the pulmonary tuberculosis patients. [t is necessary to carry out the routine drug susceptibility testing as the patients enroll the hospital and to treat in the early stage so as to ensure the appropriate timing of treatment.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2013年第11期2550-2551,共2页
Chinese Journal of Nosocomiology
关键词
肺结核
真菌感染
危险因素
Pulmonary tuberculosis
Fungal infection
Risk factor
