抗菌药物使用时间对老年肺炎患者感染假丝酵母菌属的影响

Impact of using time of antibiotics on Candida pneumonia in elderly patients

目的比较使用抗菌药物后的老年肺炎患者自然咳出痰与插管后下呼吸道痰中假丝酵母菌属的检出率。方法 158例老年肺炎的患者分为有创机械通气组（54例）和常规治疗组（104例）;分别在入院时、使用抗菌药物3-5、7-9、13-15、〉16 d进行自然咳出痰及下呼吸道吸出痰液的培养;对其中26例患者插管前后的痰进行对比研究。结果抗菌药物使用3-57、-9 d时,自然咳出痰假丝酵母菌属的检出率分别为14.42%、42.55%,显著性高于下呼吸道吸出痰（3.70%、25.93%）,差异有统计学意义（P〈0.05）;抗菌药物使用13-15、〉16 d时,两种途径假丝酵母菌属的检出率差异无统计学意义;抗菌药物使用3-15、〉16 d时同一有创机械通气患者插管前后不同途径痰中假丝酵母菌属的检出率差异无统计学意义。结论随着抗菌药物使用时间的延长,自然咳出痰中检出假丝酵母菌属可以作为肺真菌感染的参考指标。

OBJECTIVE To compare the detection rates of Candida of natural cough up sputum and sputum from lower respiratory tract after intubation in elderly patients with pneumonia after using antibiotics.METHODS A total of 158 elderly patients with pneumonia were divided into invasive mechanical ventilation group（54 cases） and the conventional therapy group（104 cases）;at the time of admission,the use of antibiotics,3-5 d,7-9 d,13-15 d, 16 d,acquiring natural cough up sputum and sputum aspiration of the lower respiratory tract to culture.Of which 26 patients before and after intubation were compared sputum.RESULTS After using antibiotic 3-5 d,7-9 d,the natural cough sputum positive rate of Candida was significantly higher than the lower respiratory tract suction sputum（data（P0.05）;after using antibiotic 13-15 d, 16 d,the detection rate of Candida in two ways was no significant difference（data P 0.05）.the detection rate of Candida in the two ways was no significant difference in the same who accepted invasive mechanical ventilation after using antibiotic for 13-15 d or 16 d.CONCLUSION With the increasing of antibiotic usage time,natural cough up sputum detection of Candida fungal can serve as a reference in pulmonary fungal infection.