慢性阻塞性肺疾病继发真菌感染的菌群分布及相关危险因素

Analysis of flora distribution and related risk factors of secondary fungal infection in chronic obstructive pulmonary disease

目的探究慢性阻塞性肺疾病(COPD)继发真菌感染的菌群分布情况及相关危险因素。方法选取2016年12月-2019年3月郑州市第七人民医院收治的COPD患者328例,根据是否继发真菌感染分为感染组(n=36),未感染组(n=292)。分析COPD继发真菌感染的菌群分布特征,对影响COPD继发真菌感染的一般资料进行单因素及多因素分析。结果 328例患者发生真菌感染36例,检出菌株40株,以酵母菌感染为主,其中白色假丝酵母菌占52.50%。Logistic回归分析,糖尿病、机械通气、血清白蛋白<35 g/L、长期使用糖皮质激素、抗生素使用时间>2周及抗生素使用种类≥3是影响COPD患者继发真菌感染的独立危险因素(OR=1.697、2.018、0.658、1.483、1.514、1.852,P<0.05)。结论避免过度和盲目使用广谱抗生素及激素,可以降低COPD继发肺部真菌感染率。

Objective To explore the distribution of fungus and related risk factors of the secondary fungal infection of chronic obstructive pulmonary disease(COPD).Methods 328 patients with COPD in The Seventh People’s Hospital of Zhengzhou from December 2016 to March 2019 were divided into infection group(n=36) and non-infection group(n=292)according to the present of secondary fungal infection.The distribution characteristics of COPD secondary fungal infection were analyzed,and the general data of COPD secondary fungal infection were analyzed by univariate and multivariate analysis.Results 36 cases of secondary fungal infection occurred in 328 patients;40 strains were detected,mainly of yeast infection,among which,white pseudofilament yeast accounted for 52.50%.Logistic regression analysis showed diabetes mellitus,mechanical ventilation,serum albumin<35 g/L,long-term glucocorticoids,use time of antibacterial drugs>2 weeks and the type of antibacterial drugs ≥ 3 were independent risk factors affecting the secondary fungal infection in COPD patients(OR=1.697,2.018,0.658,1.483,1.514,1.852,P<0.05).Conclusion Avoiding excessive and blind use of broad-spectrum antimicrobials and hormones can reduce the incidence of secondary pulmonary fungal infections in COPD.