广州市花都区80例肺结核患者继发真菌感染的研究

摘要

目的 探讨花都区肺结核患者合并真菌感染情况以及病原性真菌常见种类及其分布.方法 采集80例肺结核合并真菌感染的患者下呼吸道分泌物标本,接种MCH培养基和置温箱内25℃培养48～96 h.对分离的真菌分别以常规真菌学方法进行形态检查和生化反应.结果 从80例患者的下呼吸道分泌物标本共分离真菌99株,含酵母菌78株(78.8%)和霉菌21株(21.2%).酵母菌包括白假丝酵母菌58株、热带假丝酵母菌8株、克柔假丝酵母菌6株、季也蒙假丝酵母菌3株、褶皱假丝酵母菌l株、星形假丝酵母菌1株、葡萄牙假丝酵母菌1株.霉菌包括烟曲霉7株、黄曲霉5株、黑曲霉3株、土曲霉3株、构巢曲霉2株、展青霉l株.80例肺结核患者中,单一真菌感染者占80%,复数真菌感染者占20%.其中单一酵母菌感染者54例,占67.5%;单一霉菌感染者10例,占12.5%;酵母菌复数菌感染者8例,占10%;酵母菌与霉菌混合感染者5例,占6.3%;霉菌复数感染者3例,占3.8%.结论 花都区肺结核患者病原性真菌感染常见为酵母菌,其中主要是白假丝酵母菌.不同种类真菌感染以及复数真菌感染是肺结核患者治疗困难的一个重要因素.%Objective To investigate the epidemiology of patients with pulmonary tubcrculosis and secondary infection of fungi and probe the common species of pathogenic fungl m Huadu area. Methods Lower-respiratory secretions were collected from the 80 patients with pulmonary tuberculosis, the samples were inoculated into the CHROM agar medium and cultured at 25℃ for 48～96 h. The isolations of fungi were identified by the morphology and biochemical reaction. Results 99 strains of fungi which included 78 strains of yeasts (78.8％) and 21 strains of mold (21.2％)were isolated from the patients. The pathogenic yeasts were identified respectively as C. albicans (58 strains), C. tropicalis (8 strains), C. krusei (6 strains), C. guilliermondii(3 strains), C. rugosa (1 strain), C. stellatoidea (1 strain), C. lusitaniae (1 swain), and the pathogenic mold were identified respectively as A. fumigatus (7 strains), A. flavus (5 strains), A. niger (3 strains),A. terreus (3 strains),A. nidulans (2 strains), P. patulum (1 strain). In 80 patients with pulmonary tuberculosis, 80％ had secondary infection with single species of fungi which included 54 cases with single yeast infection (67.5％) and 10 cases with single mold infection (12.5％), and 20％ had secondary infection with multi-fungous species of fungi which included. 8 eases with the multi yeast infection (10％), 5 cases with the multi infection with yeast and mold (6.3％), 3 cases with multi mold infection (3.8％). Conclusion The yeasts were the most common species of pathogenic fungi in the patients with pulmonary tuberculosis and secondary infection of fungi, in which the C. albicans has a higher percentage in Huadu area. Infection with different or/and multi species were considered one of important factors to affect the effectiveness of patients with pulmonary tuberculosis.