2019—2023年合肥市某医院肺曲霉菌感染流行病学调查
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郭欣,硕士,主治医师,研究方向:肺部真菌感染

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R181

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Epidemiologic survey of pulmonary Aspergillus infection in a district of Hefei City, Anhui Province in 2019-2023
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    摘要:

    目的 探究安徽省合肥市某医院2019—2023年肺曲霉菌感染流行病学调查。 方法 选择2019年1月至2023年9月于安徽省胸科医院呼吸科、胸外科、肿瘤科、结核科和RICU病房就诊和治疗的302例患者资料,将曲霉菌感染患者作为观察组,念珠菌感染患者作为对照组,细菌感染作为空白组。分析患者一般资料、治疗前感染、基础疾病、抗真菌药物使用情况等。比较观察组和对照组资料,分析影响肺曲霉菌感染的危险因素。 结果 肺曲霉菌感染100例,占比33.11%。肺念珠菌感染80例,占比26.49%。其他122例为其他肺部疾病,占40.40%。肺曲霉菌感染最常见致病菌为烟曲霉(57.00%),咳嗽、咳痰及偶带血患者占大部分(88.00%),病灶多位于右肺上叶(55.00%),影像学多见单发或多发空洞(47.00%)。标本多来源于住院病人深部呼吸道,且男性病人居多。肺曲霉菌感染的危险因素有转院史、ICU入住史、机械通气、体外置管(静脉导管和尿导管)、15天内手术史、糖尿病史、呼吸道慢性疾病史、抗真菌预防史、血清指标异常。有院转运史(OR = 2.951,P=0.008)、糖尿病史(OR = 5.073,P=0.018)、呼吸道慢性疾病史(OR =7.523 ,P=0.028)、体外置管(OR =3.142,P=0.022)、有抗真菌预防史(OR = 6.334,P<0.001)是肺曲霉菌感染感染的独立危险因素。 结论 烟曲霉和黄曲霉是该医院肺曲霉菌感染的主要病原体,院转运史、体外置管、糖尿病史、呼吸道慢性疾病史和抗真菌预防史是肺曲霉菌感染的独立危险因素。

    Abstract:

    Objective To investigate the epidemiological survey of pulmonary Aspergillus infection in a district of Hefei City, Anhui Province, from 2019 to 2023. Methods The data of 302 patients who attended and were treated in the respiratory department, thoracic surgery department, oncology department, tuberculosis department and RICU ward of Anhui Chest Hospital from January 2019 to September 2023 were selected, and patients with Aspergillus infections were taken as the observation group, patients with Candida infections were taken as the control group, and bacterial infections were taken as the blank group. The general information of patients, pre-treatment infection, underlying diseases, and use of antifungal drugs were analyzed. Compare the data of observation group and control group, and analyze the risk factors affecting pulmonary Aspergillus infection. Results Pulmonary Aspergillus infection 100 cases, accounting for 33.11%. Pulmonary Candida infection was 80 cases, accounting for 26.49%. The other 122 cases were other lung diseases, accounting for 40.40%. The most common causative agent of pulmonary Aspergillus infection was Aspergillus fumigatus (57.00%), cough, sputum and occasional blood were found in most of the patients (88.00%), most of the lesions were located in the right upper lobe of the lungs (55.00%), and most of the single or multiple cavities were seen on imaging (47.00%). Specimens mostly originated from the deep airways of hospitalized patients and there was a predominance of male patients. Risk factors for pulmonary Aspergillus infection were history of hospital transfer, ICU admission, mechanical ventilation, extracorporeal catheterization (intravenous catheter and urinary catheter), history of surgery within 15 days, history of diabetes mellitus, history of respiratory chronic disease, history of antifungal prophylaxis and abnormal serum indicators. History of hospital transfer (OR=2.951, P=0.008), history of diabetes mellitus (OR=5.073, P=0.018), history of chronic respiratory disease (OR=7.523 , P=0.028), extracorporeal catheterization (OR=3.142, P=0.022), and history of anti-fungal prophylaxis (OR=6.334, P<0.001) were Aspergillus pulmonaryis infection independent risk factors for infection. Conclusion Aspergillus fumigatus and Aspergillus flavus are the main pathogens of pulmonary Aspergillus infections in the region, and a history of nosocomial transfer, extracorporeal tubes, diabetes mellitus, chronic respiratory disease, and antifungal prophylaxis are independent risk factors for pulmonary Aspergillus infections.

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  • 收稿日期:2024-12-06
  • 最后修改日期:2024-12-06
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  • 在线发布日期: 2025-01-15
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