74例肺结核继发肺部真菌感染情况分析

中国防痨杂志 ›› 2005, Vol. 27 ›› Issue (6): 380-382.

74例肺结核继发肺部真菌感染情况分析

郭新美；荣学东；马秀丽；

山东省胸科医院济南 250013；

出版日期:2005-06-10 发布日期:2005-11-03

The analysis on secondaryfungal infection of pulmonary tuberculosis cases

Guo Xinmei,Rong Xuedong,Ma Xiuli,et al.

Shandong Chest Hospital,Jinan 250013,China

Online:2005-06-10 Published:2005-11-03

摘要/Abstract

摘要： 目的　探讨山东省结核防治医院肺结核继发肺部真菌感染的危险因素、临床特点及诊治方法。方法收集2002年1月—2004年9月间山东省5家结核病防治医院临床细菌培养及鉴定获得的真菌感染病例74例并进行分析。结果 74例真菌感染中致病菌以念珠菌居多,其中白色念珠菌52例,占70.3%;光滑念珠菌9例,占12.2%;热带念珠菌5例,占6.8%;克柔念珠菌3例,占4.1%。另外还有少数近平滑念珠菌、葡萄牙念珠菌及隐球菌、曲霉菌、毛霉菌。采用科玛嘉念珠菌显色培养基,据菌落颜色判定菌种并通过ROSCO纸片扩散法,在规定时间内测定抑菌圈的直径,确定真菌菌株的敏感(S)、中介(I)与耐药(R)情况。以两性霉素B、氟胞嘧啶、氟康唑、伊曲康唑及酮康唑为对照药物,白色念珠菌敏感性较好,克柔念珠菌耐药率相对较高。感染的诱发因素多与应用抗生素和激素有关。结论肺结核较易继发真菌感染,应加强抗生素及肾上腺皮质激素的规范应用,以减少真菌感染及其耐药率的发生,有利于结核病控制及减少死亡。

关键词: 结核,肺/并发症, 肺疾病,真菌性

Abstract: Objective To study the risk factors,clinical character and means of diagnosis and treatment of secondary fungal infection of pulmonary tuberculosis cases. Method The information of 74 cases of fungi infection confirmed by culture and identification in 5 hospitals,Shandong province from January 2002 to September 2004 were collected and analysed. Results The distribution of fungi in 74 cases were Candida albicans(70.3%),Glabrata(12.2%),、C.tropicalis(6.8%)and candida krusei (4.1 %).Drug resistance rates of Amphotericin B,Fluorocytosine,Fluconazole,Itraconazole,Ketoconazole were mensurated by ROSCO paper disk diffusion.The antifungal susceptibility to Candida albicails was better and the resistance rates of candida krusei was higher. Conclusion It is common that fungal infection occurredin pulmonary tubetchlosis cases.Standardized application of antibiotic and hormone should be strengthened to reduce the rate of fungal infection and their resistance rates,which will be contribute to tuberculosis control and reduce death rate.

Key words: Pulmonary tuberculosis/complications, Lung diseases,fungal

郭新美,荣学东,马秀丽,. 74例肺结核继发肺部真菌感染情况分析[J]. 中国防痨杂志, 2005, 27(6): 380-382.

Guo Xinmei,Rong Xuedong,Ma Xiuli,et al.. The analysis on secondaryfungal infection of pulmonary tuberculosis cases[J]. Chinese Journal of Antituberculosis, 2005, 27(6): 380-382.