昆明地区患有肺部疾病的老年住院患者口腔真菌定植危险因素及药敏研究

Risk factors and drug sensitivity of oral fungal colonization in elderly inpatients with pulmonary disease in Kunming

目的:对昆明地区患有肺部疾病(主要包括肺炎、肺气肿、慢性阻塞性肺病等)的老年住院患者口腔真菌定植的高危因素进行精准分析,并对定植口腔的真菌的耐药情况进行研究。方法:选取2018年2月至2019年8月于昆明医科大学第一附属医院干疗科住院的184例的老年肺炎、肺气肿和慢性阻塞性肺病患者作为研究对象。黏膜拭子采样,CHROMagar念珠菌显色培养基进行真菌分离分析,Logistic回归分析高危因素。结果:患有肺部疾病的老年住院患者口腔真菌定植的主要危险因素为年龄大于80岁、合并有糖尿病的发生、激素的使用以及患有慢性阻塞性肺病(Chronic obstructive pulmonary disease,COPD)的老年患者。结论:患有肺部疾病的老年住院患者口腔定植的主要真菌为白色假丝酵母菌,年龄≥80岁和有义齿是主要患有COPD的老年患者口腔定植真菌的危险因素,且定植口腔的主要真菌白色假丝酵母菌,对氟康唑、伊曲康唑和伏立康唑均具有20%以上的耐药,而对两性霉素耐药比例低。

Objective:To accurately analyze the high-risk factors of oral fungal colonization in aging inpatients with pulmonary diseases in Kunming,and to study the drug resistance of fungi colonizing the oral cavity.Methods:A total of 184 elderly patients with pneumonia,emphysema and chronic obstructive pulmonary disease,who were hospitalized in the Department of Cadre Recuperation,first affiliated hospital of Kunming medical university from February 2018 to August 2019,were selected as the research subjects.Mucosal swab sampling,CHROMagar Candida chromogenic medium for fungal isolation analysis,Logistic regression analysis of high-risk factors.Results:The main risk factors for oral fungal colonization in aging inpatients with pulmonary disease were those older than 80 years of age,combined with the occurrence of diabetes,the use of hormones and male and female patients or aging patients with chronic obstructive pulmonary disease(COPD),the risk factors are different.Conclusion:The main fungus for oral colonization of aging inpatients with pulmonary disease is Candida albicans,and oral colonization fungi of aging patients with pulmonary disease,and aging patients with COPD have different risk factors,and the main fungus Candida albicans that colonize the oral cavity is more than 20%resistant to fluconazole,itraconazole and voriconazole,while the resistance rate to amphotericin is low.