结核病人呼吸道念珠菌分布特征与危险因素研究

The Investigation on the Distributive character and Danger factor of Candida in Consumptives'Respiratory Track

近几年由于感染因素改变，人类感染的菌谱发生了很大变化。结核病人感染菌谱的特征如何？很少有国内外资料报道。作者经１年检测痰样９５２份，念珠菌检出率２１．６４％，高于肠杆菌科细菌１８．４６％，绿脓杆菌１１．２８％，其它非发酵菌１０．２５％，致病性球菌２．５６％，低于革兰氏阴性杆菌４０．００％。在常见致病性菌群组成中，其构成率３３．０６％，与非发酵菌３３．８４％近似，低于革兰氏阴性杆菌６２．９１％，高于肠杆菌科细菌２９．０３％，绿脓杆菌１７．７４％，其它非发酵菌１６．１３％，致病性球菌４．０３％。１６５株念珠菌分型结果，以白色念珠菌居首６３．０３％，热带念珠菌次之２６．０６％，其它菌型少见。虽然结核病人受念珠菌感染的因素很多，但经实验证实哪些是主要危险因素报道资料很少。本文经实验证实，其主要危险因素有：１）高龄；２）气候温和４月与１１月；３）长期反复接受化疗的复治病人；４）细胞免疫水平严重下降或结核抗体水平高度上升者；５）多重耐药者。本文还对危险因素的存在导致临床多发原因进行了探讨。

Because the change of infectious factors in recent years, the bacteriagram which infect human beings have had great variation. What'S the character of the bacteriagram which infect consumptives A few materials reported about it This article reports 952 sputa samples for examination and test in a year,the result showed:the detectable rate of Candida was 21.64% which was higher than that of Enterobacteria-ceae(18,46%) and Pseudomonas,aeruginosa(11.28%),The detectable rates of others Nonferments and Pathogeny Cocci were 10.25% and 2.56% which were lower than that of Grama-negative rods(40.00%). Among the constitution of usual pathogen flora,33.06% were Candida,which was hear to the proportion of Nonferment (33.84%),but lower than the proportion of Grama-negative rods (62.91%),and higher than the proportion of Enterobacteriaceae (29.03%),Pseudomonas. aeruginosa(17.74%),others Nonferments(16.13%),Pathogeny cocci(4.03%).165 strains Candida was classified,the result indicated showed that that 63.03% were C. albicans,26.06% were C. tropicalis,other types were few. Though there are many factors causing Candida to infect consumptives ,the tests demonstrated that the most important danger factors were four points:(1)Old age. (2)Moderate climate such as April and November.(3) Patients who had accepted chemotherapy again and again for a long time.(4) The immunity level of cell decreased seriously or the level of TAb increased largely.(5) Multitudinous resistancer. This article also discussed on the cause of danger factors leading to disease.