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目的研究老年慢性阻塞性肺疾病(COPD)患者继发真菌感染的临床资料及病原菌分布,并探讨相关易感因素,为临床治疗提供可行依据。方法选取2009年1月-2013年6月医院收治的老年COPD患者1 598例为研究对象,其中67例患者继发真菌感染,采集感染患者相关标本进行真菌培养及药敏试验,对病原菌和易感因素进行统计分析。结果医院共收治1 598例老年COPD患者,其中67例继发真菌感染,感染率为4.19%;共分离出病原菌84株,其中白色假丝酵母菌、克柔假丝酵母菌、热带假丝酵母菌、隐球酵母菌属、曲霉菌属、烟曲霉菌分别占63.10%、13.10%、10.71%、5.95%、4.76%、2.38%;单因素分析显示,住院时间、侵入性操作、抗菌药物种类、抗菌药物使用时间、激素使用时间和糖尿病史是真菌感染的相关影响因素(P<0.05)。结论老年COPD患者真菌感染以肺部感染为主,检出病原菌以白色假丝酵母菌为主,在临床治疗过程中应注意真菌感染相关影响因素,采取有效预防措施,减少感染的发生。
Objective To study the clinical data and pathogens distribution of secondary fungal infections in elderly patients with chronic obstructive pulmonary disease (COPD) and explore the related susceptibility factors to provide feasible basis for clinical treatment. Methods A total of 1 598 elderly COPD patients admitted to our hospital from January 2009 to June 2013 were selected as research objects. 67 patients were infected with secondary fungal infection, and the specimens from infected patients were collected for fungal culture and drug susceptibility testing. Sense of factors for statistical analysis. Results A total of 1 598 elderly patients with COPD were admitted to the hospital, of which 67 were secondary to fungal infection with an infection rate of 4.19%. 84 pathogens were isolated from the hospital, including Candida albicans, Candida krusei, Candida tropicalis Aspergillus, Aspergillus, Aspergillus fumigatus accounted for 63.10%, 13.10%, 10.71%, 5.95%, 4.76% and 2.38% respectively. Univariate analysis showed that hospitalization time, invasive procedures, antibacterial drug types , Antimicrobial time, hormone duration and diabetes mellitus were the related factors of fungal infection (P <0.05). Conclusions The main cause of pulmonary infection in elderly COPD patients is pulmonary infection. Candida albicans is the main pathogen in the elderly. In the course of clinical treatment, we should pay attention to the influencing factors of fungal infection and take effective preventive measures to reduce the incidence of infection.