肺结核合并真菌感染的临床特点及耐药研究

Clinical Characteristics and Drug Resistance of Pulmonary Tuberculosis Complicated with Fungal Infection

目的该文研究肺结核合并真菌感染的临床特点及耐药性。方法该次研究对象选择该院在2017年3月—2019年12月之间救治的210例肺结核患者,并根据真菌感染与否将患者分为真菌感染组(102例)、非真菌感染组(108例)。对所有患者进行回顾性调查,并采集菌种进行检测,对其临床特点和耐药性进行分析。结果真菌感染组患者在空洞型肺结核、痰涂片抗酸染色阴性、肺结核复治、长期使用广谱抗生素、长期使用糖皮质激素、合并基础疾病等方面(96.08%、66.67%、76.47%、54.90%、69.61%、57.84%)明显高于非真菌感染组(63.89%、25.93%、38.89%、7.41%、17.59%、10.19%),差异有统计学意义(χ^(2)=33.380、35.085、30.253、55.846、57.953、53.615,P<0.05)。此外,白色假丝酵母菌的构成比为71.57%、热带假丝酵母菌的构成比为9.80%、隐球菌的构成比为5.88%、光滑假丝酵母菌的构成比为3.92%、曲霉菌的构成比为2.94%、克柔假丝酵母菌的构成比为3.92%、其他酵母菌的构成比为1.96%。在耐药性方面,5-氟胞嘧啶唑、两性霉素B的耐药性较低,而伊曲康唑、氟康唑具有较高的耐药性。结论在针对肺结核合并真菌感染患者的治疗过程中,应当对患者予以有效的检测,并根据患者的病情进行用药治疗,降低患者合并真菌感染的情况。

Objective This article investigates the clinical characteristics and drug resistance of tuberculosis with fungal infection.Methods The subjects of this study selected 210 pulmonary tuberculosis patients treated in the hospital between March 2017 and December 2019,and divided the patients into a fungal infection group(102 cases)and a non-fungal infection group(108 cases).All patients were retrospectively investigated,and bacterial strains were collected for testing,and their clinical characteristics and drug resistance were analyzed.Results The patients in the fungal infection group were significantly affected by cavitary tuberculosis,negative acid-fast staining of sputum smears,retreatment of tuberculosis,long-term use of broad-spectrum antibiotics,long-term use of glucocorticoids,and underlying diseases(96.08%,66.67%,76.47%,54.90%,69.61%,57.84%)were higher than the non-fungal infection group(63.89%,25.93%,38.89%,7.41%,17.59%,10.19%),the difference was statistically significant(χ^(2)=33.380,35.085,30.253,55.846,57.953,53.615,P<0.05).In addition,the composition ratio of Candida albicans was 71.57%,the composition ratio of Candida tropicalis was 9.80%,the composition ratio of Cryptococcus was 5.88%,the composition ratio of Candida glabrata was 3.92%,and the composition ratio of Aspergillus was 2.94%,the composition ratio of Candida krusei was 3.92%,and the composition ratio of other yeasts was 1.96%.In terms of drug resistance,5-fluorocytosine and amphotericin B had lower drug resistance,while itraconazole and fluconazole had higher drug resistance.Conclusion During the treatment of patients with pulmonary tuberculosis complicated with fungal infection,the patients should be effectively tested,and medication should be administered according to the patient's condition to reduce the incidence of patients with fungal infection.