66例院内并发肺假丝酵母菌病的临床分析

Clinical analysis of 66 pulmonary candidiasis cases

目的探讨院内并发肺假丝酵母菌病的易患因素、临床特点、菌种分布及药敏率。方法应用回顾性调查的方法对66例院内并发肺假丝酵母菌病的患者进行分析。结果 77.3%的患者有基础疾病,其中慢性阻塞性肺疾病(COPD)是最主要的基础疾病,占24.3%,而肺炎、肺恶性肿瘤、支气管扩张则分居第2、3、4位,分别占18.2%、12.1%、9.1%;主要的危险因素为广谱抗菌药物的使用,使用率为60.6%;院内并发肺假丝酵母菌病的临床表现无特异性,早期诊断仍困难,主要靠微生物学检查;病原菌以白色假丝酵母菌为主,占74.3%,对氟康唑及伊曲康唑耐药率高,分别为40.8%、30.6%。结论院内并发肺假丝酵母菌感染呈上升趋势,其临床表现特异性少,耐药率逐渐增高;应引起临床医师及感染控制管理部门高度重视。

OBJECTIVE To investigate the risk factor,clinical feature,distribution of fungus strain and drug sensitivity of pulmonary candidiasis in hospital.METHODS Retrospective investigation method had been taken to analysis 66 cases complicated with hospital pulmonary candidiasis.RESULTS 77.3% of all cases had underlying disease,COPD was the most common basal diseases（24.3%） and pneumonia（18.2%）,pulmonary malignant tumor（12.1%）,bronchiectasis（9.1%）were followed sequently.Main risk factors were utilizing of broad-spectrum antibiotics（60.6%）.Blastomyces albicans was the most common pathogenic bacteria（74.3%） and the resistance to fluconazol and Itraconazole was increased gradually,was 40.8% and 30.6%.There was no specific clinical manifestation of pulmonary candidiasis in hospital.Early diagnosis was rather difficult and was relied on microbiological examination.CONCLUSION The morbility of pneumonomoniliasis onset in hospital is increased in recent years,and has few specific manifestation,and its drug fast rate was increased.All of these should be paid more attention to clinician and management of infection control.