老年肺癌患者肺部真菌感染的病原学分析

Etiological analysis of pulmonary fungal infections in elderly patients with lung cancer

目的研究老年肺癌患者侵袭性肺部真菌感染的致病菌及药敏结果,为临床提高对疾病的认识提供参考。方法回顾性分析2011年1月-2014年1月96例肺癌发生侵袭性肺部真菌感染的老年患者的临床资料,统计肺癌患者真菌感染的病原菌种类及药敏结果,数据均应用SPSS 21.0进行统计处理,分析患者发生感染的危险因素。结果 96例肺癌真菌感染患者共分离出107株病原菌,以白色假丝酵母菌居多占63.55%,6种抗真菌药物中耐药率最高的为伊曲康唑27.10%,影响肺癌患者罹患侵袭性肺部真菌感染的危险因素有75岁以上高龄、吸烟史、功能状态不佳、化疗后联合放疗、化疗周期2次以上及白细胞减少。结论肺癌侵袭性肺部真菌感染的致病菌以白色假丝酵母菌、热带假丝酵母菌为主;常用抗真菌药物耐药率较小的分别为氟胞嘧啶、两性霉素B等。

OBJECTIVE To study pathogens for invasive pulmonary fungal infections in elderly patients with lung cancer and drug susceptibility results,so as to provide reference for improvement of clinical awareness of these diseases.METHODS A retrospective analysis was conducted on clinical data of 96 cases of invasive pulmonary fungal infection in elderly patients with lung cancer in Jan.2011-Jan.2014.The types of pathogens and the drug susceptibility results for these lung cancer patients were statistically summarized and the software SPSS21.0was used for data process and the risk factors for infection were analyzed.RESULTS Totally 107 pathogenic strains were isolated from the 96 cases of lung cancer patients with fungal infections,with the majority of Candida albicans accounting for 63.55%.Among the six kinds of antifungal drugs,itraconazole had the highest rate of drug resistance of27.10%.The risk factors for lung cancer patients suffering from invasive pulmonary fungal infection were age over 75 years,smoking history,poor functional status,combined treatment of radiotherapy after chemotherapy,chemotherapy cycle more than 2times,and neutropenia.CONCLUSIONPathogens for invasive pulmonary fungal infections in lung cancer are mainly C.albicans and Candida tropicalis.The commonly used antifungal drugs with lower resistance rates are fluorocytosine and amphotericin B.