Clinical Analysis Of Secondary Fungus Infection In Patients With Chronic Obstructive Pulmonary Disease In Acute Exacerbation

Objective: To analyze the morbidity, mortality, and risk factors of secondary fungus infection in patients with chronic obstructive pulmonary disease (COPD) in acute exacerbation for preventing and treating it.Methods: From Dec. 1998 to Jan. 2001 West China Hospital's data banks were queried for patients with COPD. A retrospective study was undertaken in 937 cases with 205 patients who had secondary fungus infection. The clinical characteristics, risk factors, distribution of pathogens and prognosis were compared between two groups with or without secondary fungus infection.Results: There was 205 patients (21.88%) who had secondary fungus infection in 937 cases with COPD and nosocomial fungal infection occurred in 166 out of 205 patients. 8 kinds of strains were found, and albiacns, Candida albiacns, and C. tropcalis were the major pathogens (48.18%, 33.60% and 9.31% respectively). 46 kinds of antibiotics were used in the patients with secondary fungus infection and mean treated duration was much longer than that in patients without secondary fungus infection (P<0.01). Steroids were used in 123 out of 205 patients with secondary fungus infection and the steroid-treating duration was further longer than patients without secondary fungus infection (P<0.01). 49 patients treated with intervenient operation in 205 were more than 82 patients in those without secondary fungus infection (23.90% vs 11.20%, P<0.001). 33 out of 205 patients with secondary fungus infection died, and 57 in 732 patients without secondary fungus infection died. Correlation showed that duration of antibiotics, hospitalized duration, and steroid-treating duration had the positive relationship with the occurrence offungus infection. Logistic regression analysis suggested that age, hospitalizedduration, steroid and antibiotics are significant risk factors.Conclusion: Secondary fungus infection in patients with COPD is considered whenold age, long-term hospitalized duration, antibiotics used for a long time and with alarge mount, steroids and intervenient operation are present.