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目的探讨我院内科病房患者肺部真菌感染发病的易患因素、临床特征和治疗。方法采用回顾性调查方法对2004年7月至2008年12月收住内科的经微生物检查证实45例继发肺部真菌感染的患者进行分析。结果在内科病房中,院内肺部真菌感染发生率为2.4%,慢性阻塞性肺疾病(55.6%)是继发院内肺部真菌感染最常见的基础疾病,长期使用广谱抗生素(91.1%)、低蛋白血症(42.2%)、长期使用糖皮质激素(35.5%)及合并糖尿病是主要易患因素。肺部真菌感染的临床表现无特异性,确诊需结合痰培养,组织病理学和临床表现来确定,病原菌以白色假丝酵母菌(71.1%)为主,氟康唑治疗有效率91.6%。结论院内肺部真菌是呼吸系统疾病继发感染的重要病原体,而白色假丝酵母菌是院内肺部真菌感染的主要致病菌,有效的抗真菌治疗外,积极的综合治疗有助于提高真菌感染的治愈率。
Objective To investigate the risk factors, clinical features and treatment of pulmonary fungal infection in medical wards of our hospital. Methods A retrospective survey was performed to analyze 45 patients with secondary pulmonary fungal infection confirmed by microbiological examination from July 2004 to December 2008 in the medical department. Results In the medical ward, the incidence of pulmonary fungal infection in the hospital was 2.4%. Chronic obstructive pulmonary disease (55.6%) was the most common underlying disease of secondary pulmonary fungal infection in the hospital. Long-term use of broad-spectrum antibiotics (91.1%), Hypoproteinemia (42.2%), long-term use of glucocorticoids (35.5%) and diabetes mellitus are major predisposing factors. The clinical manifestations of pulmonary fungal infection were nonspecific. The diagnosis should be confirmed by sputum culture, histopathology and clinical manifestations. The pathogen was Candida albicans (71.1%) and the fluconazole treatment was 91.6%. Conclusions Pulmonary fungi in the hospital are important pathogens of secondary respiratory infection. Candida albicans is the main pathogen of nosocomial pulmonary fungal infection. In addition to effective antifungal therapy, positive integrated therapy can help to increase fungi The cure rate of infection.