63例肺真菌病临床与病原学调查

Clinical and etiological survey of 63 patients with pulmonary mycosis

目的了解肺真菌病的临床特点及病原菌分布,以提高临床医师对该病的认识。方法回顾性调查2009年1月-2011年12月河北联合大学附属开滦总医院肺真菌病感染住院患者的临床资料。结果临床确诊肺真菌病患者63例,肺假丝酵母菌病最多,为38例,肺曲霉菌病25例,未发现肺隐球酵母菌病、肺组织胞浆菌病、肺孢子丝菌病;社区感染35例,医院感染28例;63例肺真菌感染患者主要分布在呼吸内科、神经内科,分别为32例和9例;7株医院感染假丝酵母菌属对5种抗真菌药物全部敏感;31株社区感染假丝酵母菌属对5种抗真菌药物的耐药率均<20.00%。结论应做活检病理组织学检查,以便明确诊断,同时临床医师应提高对肺真菌病的认识,积极对症治疗,提高治愈率。

OBJECTIVE To understand the clinical characteristics of pulmonary mycosis and the distribution of pathogenic bacteria so as to improve the awareness of clinicians about this disease.METHODS The clinical data of the pulmonary mycosis patients who enrolled the Affiliated Kailuan Hospital of Hebei United University from Jan 2009 to Dec 2011 were retrospectively investigated.RESULTS Among 63 patients who were clinically diagnosed as the pulmonary mycosis,there were 38 cases of patients with pulmonary candidiasis,25 cases of patients with pulmonary aspergillosis,however,the pulmonary crytococcosis,lung histoplasmosis and pneumocystis have not been found.There were 35 cases with community-acquired infections and 28 cases with hospital-acquired infections.Totally 63 pulmonary mycosis patients mainly distributed in the respiratory department of internal medicine（32 cases） and neurology department（9 cases）.All of the 7 strains of Candida causing hospital infections were sensitive to 5 antifungal agents,and the drug resistance rates of 31 strains of Candida causing the community-acquired infections to 5 antifungal agents were less than 20.00%.CONCLUSION In order to clarify diagnosis of pulmonary mycosis,biopsy pathological examination is necessary.At the same time,it is necessary for the doctors to improve the awareness of the pulmonary mycosis and to implement the symptomatic treatment actively so as to raise the cure rate.