Rrelated factors of pulmonary fungal infections in patients with acute exacerbation of chronic obstructive pulmonary disease

OBJECTIVE To study the related factors of pulmonary infections in the patients with acute exacerbation of chronic obstructive pulmonary disease(COPD) and analyze the drug resistance so as to reduce the incidence of pulmonary infections in the patients with acute exacerbation of COPD.METHODS A total of 68 cases of acute exacerbations of COPD patients complicated with pulmonary infections,who were treated in the hospital from Jan 2009 to Jun 2012,were selected as the pulmonary infection group,while 68 cases of acute exacerbation of COPD patients without pulmonary infections were chosen as the non-pulmonary infection group,then the clinical data of the two groups of patients were retrospectively analyzed,and the related factors for the fungal infections were analyzed.RESULTS A total of 81strains of fungi were isolated,among which the Candida albicans was the predominant species,accounting for 45.68%,followed by Aspergillus fumigatus(25.93%) and other Candida(17.28%).The drug resistance rates to flucytosine,amphotericin B,the ball erythromycin,mepartricin,g mycophenolate Ling,fluconazole and itraconazole were less than 30.00%.The univariate analysis indicated that the long-term use of antibiotics and hormones,hypoalbuminemia,and mechanical ventilation were the risk factors;the multivariate logistic analysis showed that the complication of diabetes,hypoproteinemia,and long-term use of antibiotics were the important risk factors that resulted in the pulmonary infections in the elderly patients with acute exacerbations of COPD.CONCLUSION The pulmonary infections in the elderly patients with acute exacerbation of COPD are mainly associated with the long-term use of antibiotics,hypoalbuminemia,or diabetes.The fungi are highly drug resistant,it is necessary for the hospital to reasonably use antibiotics.