呼吸内科老年患者真菌感染的临床特点及耐药性分析

Clinical Characteristics and Drug Resistance Analysis of Fungal Infection in Elderly Patients of Respiratory Medicine Department

目的:分析呼吸内科老年患者真菌感染的临床特点及耐药性。方法:选取2021年1月—2022年12月泰安八十八医院呼吸内科收治的老年真菌感染患者187例作为研究对象。收集患者资料,鉴定感染真菌类型,检测念珠菌耐药性。结果:187例老年真菌感染患者中,肺部疾病以慢性阻塞性肺疾病占比最高;合并症以心血管系统疾病居多,其次为恶性肿瘤、中枢神经系统疾病;共检出7种真菌,主要为白念珠菌,其次为光滑念珠菌、热带念珠菌。白念珠菌对氟康唑、伊曲康唑、伏立康唑、两性霉素B、氟胞嘧啶均有一定耐药性,光滑念珠菌对两性霉素B敏感,热带念珠菌对伊曲康唑、伏立康唑、两性霉素B、氟胞嘧啶敏感,克柔念珠菌对伊曲康唑敏感。结论:老年患者感染的真菌主要为念珠菌,临床应重视真菌鉴定及药敏试验,合理使用抗菌药。

Objective:To analyze the clinical characteristics and drug resistance of fungal infection in elderly patients of respiratory medicine department.Methods:A total of 187 elderly patients with fungal infection admitted to Respiratory Medicine Department of No.88 Hospital in Taian from January 2021 to December 2022 were selected as the study subjects.Patient's data were collected,the type of fungus infected was identified,and Candida resistance was detected.Results:Among the 187 elderly patients with fungal infection,chronic obstructive pulmonary disease accounted for the highest proportion of lung diseases.The comorbidities were mostly cardiovascular system diseases,followed by malignant tumors and central nervous system diseases.A total of 7 types of fungi were detected,mainly Candida albicans,followed by Candida glabrata and Candida tropicalis.Candida albicans had certain resistance to fluconazole,itraconazole,voriconazole,amphotericin B,and flucytosine;Candida glabrata was sensitive to amphotericin B;Candida tropicalis was sensitive to itraconazole,voriconazole,amphotericin B,and flucytosine;Candida krusei was sensitive to itraconazole.Conclusion:Candida is the main fungus infected by elderly patients.Clinical attention should be paid to fungal identification and drug susceptibility test,and antimicrobial drugs should be used rationally.