摘要
目的对近十二年国内外肺部真菌感染的现状进行系统性荟萃分析,了解肺部真菌感染危险因素及病原菌分布,为临床诊疗提供依据。方法计算机检索CNKI、万方、PubMed和Web of Science数据库中2007年-2019年9月发表的关于肺部真菌感染的相关文献,由两名评价员根据纳入及排除标准独立筛选文献,根据数据和质量评价后,对结果进行汇总和分析。结果本研究最终纳入41篇文献。荟萃分析结果显示,肺部真菌感染的综合病死率为21%(95%CI:0.17~0.25)。纳入的2983例病例发生肺部真菌感染的危险因素主要包括抗生素的长期使用,免疫抑制剂的使用,侵入性操作,患者营养状况差,粒细胞减少以及患有恶性肿瘤。病原学诊断表明,假丝酵母菌属(77.11%)和曲霉菌属(15.60%)是肺部真菌感染最常见病原菌属。假丝酵母菌属中白假丝酵母占55.91%,其次是热带假丝酵母占11.15%。结论肺部真菌感染有着较高的病死率,临床表现无特异性,其感染风险与患者的自身基础疾病和治疗因素均有关,医生对于疑似病例应给予高度重视和密切监测,尽快确诊,并选择有效的抗真菌药物进行治疗。
OBJECTIVE To investigate the risk factors for pulmonary fungal infection and distribution of pathogens by means of systematic meta-analysis of current status of pulmonary fungal infection in China and abroad in the nearly past two decades so as to provide guidance for clinical diagnosis and treatment. METHODS The literatures in relevant to pulmonary fungal infection were retrieved from the databases including CNKI, Wanfang, Pubmed and Web of Science from 2007 to Sep 2019, the literatures were screened out by two valuators based on the inclusion and exclusion criteria, and the results were summarized and observed after the data and quality were evaluated. RESULTS Totally 41 literatures were finally included in the study.The result of meta-analysis showed that the overall mortality rate was 21%(95%CI:0.17~0.25).The major risk factors for the pulmonary infections in the included 2983 patients included long-term use of antibiotics, use of immunosuppressors, invasive operation, poor nutrition status, granulocytopenia and malignant tumor.The etiologic diagnosis indicated that Candida(77.11%) and Aspergillus(15.60%) were the most common pathogens causing the pulmonary fungal infection.Among the Candida species, Candida albicans accounted for 55.91%, Candida tropicalis 11.15%. CONCLUSION The mortality rate of the patients with pulmonary fungal infection is high, the patients do not have specific clinical manifestations, the infection is associated with the underlying diseases and treatment factors, and it is necessary for doctors to pay great attention to the suspected cases, make the diagnosis as early as possible and choose effective antifungal drugs for treatment.
作者
单明珠
颜鸣菊
朱作斌
陈莹
顾兵
李颖
SHAN Ming-zhu;YAN Ming-ju;ZHU Zuo-bin;CHEN Ying;GU Bing;LI Ying(Medical Technology School,Xuzhou Medical University,Xuzhou,Jiangsu 221004,China;不详)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2020年第2期174-179,共6页
Chinese Journal of Nosocomiology
基金
江苏省高等学校自然科学研究基金资助项目(17KJB360014)。
关键词
肺部真菌感染
死亡
危险因素
病原菌
荟萃分析
Pulmonary fungal infection
Mortality
Risk factor
Pathogen
Meta-analysis
