摘要
目的分析慢性阻塞性肺疾病急性加重期(AECOPD)合并侵袭性肺部真菌感染(IPFI)的病原菌特征及危险因素。方法回顾性选取2019年12月-2020年12月安吉县第二人民医院收治的65例AECOPD合并IPFI患者为感染组,另随机选取同期医院收治的65例AECOPD未合并IPFI患者为未感染组。分析感染组患者痰液培养菌种分布及主要菌种耐药性,将两组患者各项临床资料进行单因素分析比较,并采用多因素Logistic回归分析影响AECOPD患者并发IPFI的危险因素。结果65例AECOPD合并IPFI患者共分离出115株病原菌,分离菌株以白假丝酵母(41.74%)和热带假丝酵母(22.61%)为主;且热带假丝酵母对氟康唑、伏立康唑、伊曲康唑均有一定的耐药性,白假丝酵母和热带假丝酵母均对两性霉素B完全敏感。Logistic回归分析显示,有糖尿病史、合并低蛋白血症、抗菌药物使用种类>2种、有机械通气均为影响AECOPD患者并发IPFI的危险因素。结论AECOPD合并IPFI患者主要感染病原菌为白假丝酵母和热带假丝酵母,且存在有糖尿病史、合并低蛋白血症、抗菌药物使用种类>2种、机械通气是发生IPFI的危险因素,此类患者是发生IPFI的高危人群。
OBJECTIVE To explore the etiological characteristics and risk factors for invasive pulmonary fungal infection(IPFI)in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).METHODS A total of 65 AECOPD patients complicated with IPFI who were treated in Anji County Second People’s Hospital from Dec 2019 to Dec 2020 were retrospectively enrolled in the study and assigned as the infection group,meanwhile,65 AECOPD patients who were not complicated with IPFI were chosen as the no infection group.The species of pathogens isolated from sputum specimens and drug resistance of major species were observed,univariate analysis was performed for the clinical data,and multivariate logistic regression analysis was carried out for the risk factors for IPFI in the AECOPD patients.RESULTS Totally 115 strains of pathogens were isolated from the 65 AECOPD patients complicated with IPFI,among which Candida albicans and Candida tropicalis were dominant,accounting for 41.74%and 22.61%,respectively.C.tropicvalis showed certain resistance to fluconazole,voriconazole and itraconazole;C.albicans and C.tropicalis were completely sensitive to amphotericin B.Logistic regression analysis showed that the history of diabetes mellitus,complication with hypoproteinemia,use of more than 2 types of antibiotics and mechanical ventilation were the risk factors for IPFI in the AECOPD patients.CONCLUSION C.albicans and C.tropicalis are the predominant species of pathogens causing IPFI in the AECOPD patients.The history of diabetes mellitus,complication with hypoproteinemia,use of more than 2 types of antibiotics and mechanical ventilation are the risk factors for IPFI,and the patients are the population at high risk of IPFI.
作者
吉为平
张双美
赵宏
邰争营
戴红丽
JI Wei-ping;ZHANG Shuang-mei;ZHAO Hong;TAI Zheng-ying;DAI Hong-li(Anji County Second People's Hospital,Huzhou,Zhejiang 310003,China;不详)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2022年第13期1965-1968,共4页
Chinese Journal of Nosocomiology
基金
湖州市科技局基金资助项目(2019GYB62)。
关键词
慢性阻塞性肺疾病急性加重期
侵袭性肺部真菌感染
病原菌
耐药性
危险因素
Acute exacerbation of chronic obstructive pulmonary disease
Invasive pulmonary fungal infection
Pathogen
Drug resistance
Risk factor
