慢性阻塞性肺疾病患者继发真菌性医院肺炎的病原菌分布及耐药性分析

目的探讨慢性阻塞性肺疾病（Chronic obstructive pulmonary diseases,COPD）患者继发真菌性医院肺炎的病原菌分布及耐药情况。方法回顾性分析2011年1月至2012年12月间31例COPD患者继发肺部真菌感染的情况。结果 31例COPD继发肺部真菌感染的患者送检标本中共检到34株真菌,以曲霉菌属居首位,占29.41%,其次为白色假丝酵母菌,占26.41%。7种常用抗真菌药物对真菌显示有不同的抗菌活性,尤以伊曲康唑、氟康唑、5-氟胞嘧啶为佳。结论 COPD患者继发肺部真菌感染多为曲霉菌属和白色假丝酵母菌。临床疑为COPD患者继发肺部真菌感染病例须及时采集标本培养,以早期发现病原性真菌和选择有效药物治疗。

Distribution and drug resistance of fungi in pulmonary fungal .infection Secondary to chronic obstructive pulmonary disease

Objective To investigate the distribution and drug resistance of pathogens in pulmonary fungal infection secondary to chronic obstructive pulmonary disease （COPD）. Methods Retrospective review was performed to analyze the data of 31 COPD patients with secondary pulmonary fungal infection between January 2011 and January 2012. Results Among the 3 l cases of COPD with secondary infection, 34 strains of fungi were detected, in which Aspergillus species ranking first （29.41%）, followed by Candida albicans （26.41%）. Seven kinds of common antifungal drugs showed different antibacterial activity against these fungal strains, especially itraconazole, Fluconazole and 5-fluoroeytosine. Conclusion Aspergillus and Candida albicans are the major pathogens in COPD patients with secondary fungus infection. Clinical specimens should be collected and detected in case of suspected fungus infection so as to take appropriate treatment as early as possible.