慢性阻塞性肺疾病患者继发肺部真菌感染的临床分析  

Clinical analysis of secondary pulmonary fungal infection in patients with chronic obstructive pulmonary disease

作　　者：谭红霞[1,2] 武晓兰[1,2] 汪浩[1,2] 王昌会[3] 范晓云[1,2] 

机构地区：[1]安徽医科大学第一附属医院老年呼吸内科,安徽合肥230022 [2]安徽医科大学呼吸病研究所,安徽合肥230022 [3]安徽医科大学第一附属医院心内科,安徽合肥230022

出　　处：《中国微生态学杂志》2011年第12期1097-1099,1103,共4页Chinese Journal of Microecology

基　　金：国家自然科学基金项目(81100027);安徽省高校省级自然科学研究项目(KJ2011A176);安徽省教育厅教学研究项目(20100350)

摘　　要：目的探讨慢性阻塞性肺疾病(COPD)患者继发肺部真菌感染的临床特点。方法回顾性分析2008年1月到2010年12月安徽医科大学第一附属医院收治的COPD继发肺部真菌感染患者病例,并对其耐药情况进行比较。结果本组199例COPD患者检出白色念珠菌137例(68.84%),光滑念珠菌32例(16.08%),热带念珠菌17例(8.54%),克柔念珠菌9例(4.52%),毛霉菌3例(1.51%),清酒假丝酵母菌1例(0.50%);白色念珠菌检出率有下降趋势,热带念珠菌有上升趋势;196例真菌对伏立康唑、氟康唑、两性霉素B、伊曲康唑、氟胞嘧啶的耐药率分别为3.6%、5.1%、1.0%、8.7%和0;2008年至2010年白色念珠菌和光滑念珠菌耐药率变化差异无统计学意义。结论 COPD患者继发肺部真菌感染病原菌仍以白色念珠菌为主,其次为光滑念珠菌和热带念珠菌;白色念珠菌和光滑念珠菌耐药率无明显改变。Objective To investigate the clinical characteristics of secondary pulmonary fungal infection in chronic obstructive pulmonary disease （COPD） patients. Method A total of 199 cases were analysed retrospectively of COPD with secondary pulmonary fungal infection from Jan. 2008 to Dee. 2010 in our hospital, and the resistance rates were compared. Result Among the 199 cases, candida albicans in 137 cases （68. 84%）, candida glabrata in 32 cases （ 8.54% ） , candida tropicalis in 17 cases （ 8.54% ）, eandida krusei in 9 cases （ 4.52% ）, mucor in 3 cases （ 1.51% ） , other eandida in 1 case （0.50%）, were detected. The detection rates of eandida albicans tend to decline, and that of candida tropicalis tend to rise. 196 cases of fungus were performed drug sensitivity test, and then the resistance rate to voriconazole, fluconazole, amphotericin B, itraconazole and 5-flucytosine were 3.6%, 5.1%, 1.0%, 8.7% and 0, respectively. However, the drug resistance change showed no significant difference in candida albicans and candida glabrata between 2008 and 2010. Conclusion Candida albicans is still the major pathogenic bacterium in patients with COPD and secondary pulmonary fungal infection, followed by candida glabrata and candida tropicalis. The drug resistance of candida albicans and candida glabrata did not change obviously.

关 键 词：慢性阻塞性肺疾病 真菌感染 耐药性分析 

分 类 号：R378[医药卫生—病原生物学]