摘要
目的探讨老年冠心病患者隐球酵母菌性肺炎的临床特点和耐药性,为临床诊治提供参考依据。方法选取2005年1月-2014年4月发生医院隐球酵母菌性肺炎的老年冠心病患者48例,回顾性分析其临床资料,对临床表现和辅助检查结果进行统计,并通过纸片扩散法对隐球酵母菌属耐药性进行监测,数据采用SPSS 17.0软件进行统计分析。结果 48例隐球酵母菌性肺炎患者临床表现以呼吸系统为主,共34例,占70.83%;行影像学检查时发现肺部以结节肿块型最为常见,共32例占66.67%;48株隐球酵母菌属对伊曲康唑、氟康唑的耐药率均达到22.92%,对咪康唑耐药率达到20.83%;对两性霉素B、制霉菌素以及益康唑的耐药性均仅有8.33%,敏感性分别为91.67%、89.58%和81.25%。结论老年冠心病患者隐球酵母菌属感染临床症状不典型,临床应结合多项辅助检查结果进行判断,早期经验性用药以两性霉素B为首选,而通过药敏试验结果为患者制定更为个体化的治疗方案。
OBJECTIVE To investigate clinical features of eryptoeoccal pneumonia in old patients with coronary heart disease and the drug resistance of the pathogens so as to provide references for clinical diagnosis and treatments. METHODS Totally 48 old patients with coronary artery diseases who appeared cryptococcal pneumonia from Jan. 2005 to Apr. 2014 were selected. The clinical data of them were retrospectively analyzed. And their clinical manifestations and assistant examinations were recorded. Disk diffusion method was adopted to monitor the drug resistance. SPSS 17.0 was adopted for statistical analysis. RESULTS A total of 34 cases in the 48 manifested as respiratory system infections, accounting for 70. 83%. The imageological examination found that lung nodules were the most common in those patients with 32 cases, holding 66.67%. The drug resistance rate of the 48 strains of Cryptococcus neoformans to itraconazole and fluconazole was up to 22. 92%, to miconazole was 20.83% and to amphotericin B, nystatin and econazole was only 8.33%. The drug sensitive rates of tlaose strains to the above antibiotics were 91.67%, 89.58%and 81.25% respectively. CONCLUSION Elderly patients with coronary artery disease and lung infections caused by C. neoformans have untypical clinical symptoms. Clinical test results should be combined With a number of auxiliary inspections. Early empiric treatment should choose Amphotericin B firstly and formulate individualized plans according to results of drug sensitivity tests.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2015年第24期5543-5545,共3页
Chinese Journal of Nosocomiology
基金
浙江省卫生厅基金资助项目(ZW-2012B-019)
关键词
老年患者
冠心病
隐球酵母菌属
肺炎
Elderly patients
Coronary artery disease
Cryptococcus neoforrtians
Pneumonia
