肺结核患者合并医院真菌感染的相关因素分析

Risk factors for hospital-acquired fungal infections in patients with pulmonary tuberculosis

目的探讨肺结核患者合并医院真菌感染的菌种分类及感染相关危险因素,为临床预防和治疗真菌感染提供参考依据。方法回顾性调查156例肺结核合并医院真菌感染患者的病案资料,真菌培养与药敏试验按照《全国临床检验操作规程》进行。结果肺结核患者真菌感染部位以呼吸道感染率最高,占67.3%;主要病原性真菌为白色假丝酵母菌、光滑假丝酵母菌、热带假丝酵母菌,分别占61.5%、15.4%、8.3%;真菌感染的危险因素为患者原发结核病的严重程度、年龄、住院天数、接受多种侵入性诊疗操作等。结论临床医师应采取干预措施,预防肺结核患者发生医院真菌感染。

OBJECTIVE To approach the species of the fungi causing hospital acquired infections in patients with pulmonary tuberculosis and explore the related risk factors, so as to provide basis for clinical prevention and treatment of fungal infections. METHODS The retrospective review was performed for the medical records of 156 tuberculosis patients with hospital acquired fungal infections, fungal culture and drug susceptibility testing were carried out by referring to National Guides to Clinical Laboratory Procedures. RESULTS The rate of respiratory tract infection was the highest （67. 3%）; the main pathogenic fungi comprised of Candida albicans （61. 5 %）, C. glabrata （15.4%）, and C. tropicalis （8. 3%） the risk factors for fungal infections were the severity of primary pulmonary tuberculosis, age, length of hospital stay, and invasive medical operation. CONCLUSION The clinicians should take corresponding intervention measures to prevent hospital acquired fungal infections in patients with pulmonary tuberculosis.