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Chinese Journal of Mycology 2018, Vol. 13  Issue (1): 15-19.

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High risk factors and clinical efficacy of pulmonary fungal infection in patients with acute exacerbation of chronic obstructive pulmonary disease

WANG Qun, ZHANG Qiang, HUANG Jing, HAN Shu-hua, ZHU Xiao-li   

  1. Department of Respiratory, Zhongda hospital, Southeast University, Nanjing 210009
  • Received:2017-08-22 Online:2018-02-28 Published:2018-02-28

Abstract:

Objective To further explore the high-risk factors of secondary fungal infection in patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease (AECOPD)and to analyze whether differences of clinical efficacy and expenses exist among the group of clinically diagnosed and suspected. Method This study to collect the clinical data of AECOPD from January 2014 to August 2017 in the Department of respiration in our hospital, and to analysis the sex, age, course of disease, basic disease, antibiotics, corticosteroids, hospitalization time, costs and clinical efficacy. Result This study included 633 AECOPD patients in total, 90 cases with pulmonary fungal infection. The risk factors of secondary pulmonary fungal infection in COPD patients were age (≥ 70 years), course (≥ 10 years), basic diseases (≥ 2 kinds), the use of combination antibiotics and systemic hormone (P<0.05). Of 90 pulmonary fungal infection patients, 4 cases were correctly diagnosed (excluded), 41 cases were clinically diagnosed and 45 cases were suspected. No differences were observed on gender, age, course, basic diseases, the use of antibiotics and hormone, and clinical effects in the latter two groups, but the group of suspected was better than the group of clinically diagnosed on hospitalization time (P=0.016) and costs (P=0.019). Conclusion High risk factors for fungal infection should be assessed as early as possible for patients with AECOPD who were not adequately treated with conventional anti-infection therapy. Early antifungal therapy for suspected patients can reduce hospitalization time and costs.

Key words: AECOPD, fungal infection, high-risk factor, clinical efficacy

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