某三甲医院COVID-19继发真菌感染患者的病原谱分析  

Pathogen Spectrum of Coronavirus Disease-2019(COVID-19)Associated Fungal Infection Patients of a Class A Tertiary Hospital

作　　者：胡音音 王菲[1] 刘红霞[1] 董娅[1] 崔岭峰 卢庆文[1] Hu Yin-yin;Wang Fei;Liu Hong-xia;Dong Ya;Cui Ling-feng;Lu Qing-wen(Department of Clinical Laboratory,Nan yang Central Hospital,Henan,Nanyang 473000)

机构地区：[1]南阳市中心医院医学检验科,河南南阳473000

出　　处：《国外医药（抗生素分册）》2024年第5期336-341,共6页World Notes on Antibiotics

摘　　要：目的分析2022年12月10日—2023年6月20日某三甲医院新型冠状病毒感染(COVID-19)继发真菌感染患者的真菌病原谱,为COVID-19继发真菌感染提供病原学依据。方法回顾性分析2022年12月10日—2023年6月20日我院COVID-19合并真菌感染患者的真菌病原谱,包括病原菌分布、标本来源及其与性别、年龄的相关性。所有纳入研究的患者均确诊COVID-19并符合侵袭性真菌感染分级诊疗中的确诊或临床诊断级别。真菌鉴定采用基质辅助激光解析电离飞行时间质谱技术进行,丝状真菌的鉴定根据菌落形态、镜下形态及质谱结果进行。结果2022年12月10日—2023年6月20日我院102例COVID-19合并真菌感染的患者,共检出真菌116株,其中曲霉57株(49.41%)、念珠菌49株(42.24%)、根霉4株(3.45%)、其他类真菌6株(5.17%),14例患者同时检出2种真菌。不同年龄组患者的真菌检出差异有统计学意义(P<0.001);不同性别组曲霉属和烟曲霉的检出差异有统计学意义(P=0.005和P=0.008);不同年龄组念珠菌属、曲霉属、白色念珠菌、黄曲霉和烟曲霉的检出差异有统计学意义(P<0.001,P<0.001,P=0.006,P<0.001和P=0.009)。不同年龄组的患者真菌检出构成比以60岁~79岁最高(62.93%),其次为80岁~90岁(21.55%)。结论COVID-19患者真菌病原谱以曲霉和念珠菌为主,其中白色念珠菌和黄曲霉最常见,少见重要临床致病真菌应引起重视,60岁以上老年COVID-19患者最易合并真菌感染。Objective To understand the spectrum of fungi of COVID-19 complicated with fungal infection patients in a third class A hospital from 10th December 2022 to 20th June 2023,providing pathogenic basis for COVID-19-associated fungal infections.Methods Retrospective analysis of the pathogen spectrum of COVID-19 is complicated by fungal infection patients,including the distribution of pathogens and sources of specimens and the correlation of fungi isolates with gender and age.All COVID-19 patients included in this study meet the confirmed diagnosis or clinical diagnosis criteria of invasive fungal infection.Identification of fungi uses the matrixassisted laser desorption ionization time-of-flight Mass Spectrometry(MALDI-TOF-MS).For filamentous fungi were identified according to their colony and macroscopic characteristics and MALDI-TOF-MS.Results A total of 116 fungi were found in the 102 COVID-19 patients that were complicated by fungal infection between December 10,2022,and June 20,2023.The positive rates and strain numbers for Aspergillus,Candida,Rhizopus,and other classes were 57(49.41%),49(42.24%),4(3.45%),and 6(5.17%)respectively.14 patients were detected with two fungi.The detection of fungi in different age groups has statistical significance(P<0.001).There is statistical significance in the identification of Aspergillus and Aspergillus fumigatus indifferent gender groups(P=0.005 and P=0.008,respectively).The detection of Candida,Aspergillus,Candida albicans,Aspergillus flavus and Aspergillus fumigatusin different age groups has statistical significance(P<0.001,P<0.001,P=0.006,P<0.001 and P=0.009 respectively).The age group 80~90 years old had the second-highest constituent ratio(21.55%),after the 60~79 age group(62.93%).Conclusion Spectrum of fungi in COVID-19 patients were mainly candida and Aspergillus with Candida albicans and Aspergillus flavus being the most common,rare and important clinical fungi that should be paid attention to COVID-19 patients aged 60 years or above are susceptible to occur fungal co

关 键 词：新型冠状病毒感染 真菌感染 病原谱 曲霉 念珠菌 

分 类 号：R978.5[医药卫生—药品]