老年下呼吸道感染住院期间继发真菌感染的临床分析

Analysis of the risk factors of lower respiratory tract infection with secondary fungus infection in elderly inpatients

目的探讨老年下呼吸道感染院内继发真菌感染的危险因素,以提高诊治水平。方法分析56例住院老年下呼吸道感染患者的临床资料,动态观察痰培养发现真菌,或虽未发现真菌而用抗真菌药物治疗有效的,为继发真菌感染组30例。而继续用抗菌素治愈的,为非继发真菌感染26例。从而对危险因素、抗菌药物种类和应用时间、糖皮质激素的应用、营养状况和基础疾病等进行分析。结果真菌发生率与抗菌素使用时间的长短,是否应用糖皮质激素,住院时患者营养状况好坏,是否合并糖尿病明显有关。结论认识老年下呼吸道感染住院患者的危险因素,争对性应用抗真菌药物可提高疗效。

Objective To analyze the risk factors of 56 cases with lower respiratory tract infection with secondary fungus infection in elderly inpatients, then to improve diagnosis and treatment level. Methods To retrospectively study the clinical materials of 56 eases with lower respiratory tract infection in elderly inpatients. By dynamic observation of sputum culture, 30 patients are diagnosed as secondary fungus infection, because we find fungus in sputum, or it is curative by antimycotic therapy although withoutfinding fungus; 26 patients are non- secondary fungus infection, which are cured by antibiotic therapy and without finding fungus. Then we analyze the risk factors, sorts and time of antibiotic therapy, glucocorticoid, nutrition state and underlying diseases, etc. Results Incidence rate of secondary fungus infection is closely related to the time of antibiotic therapy, whether applying glucocorticoid, the nutrition state of inpatients and whether complication with diabetes. Conelusions By studying the risk factors of lower respiratory tract infection in elderly inpatients, it is recommended that etiotropic antimicotic therapy can improve treatment effectiveness.