The Clinical Analysis Of Pulmonary Tuberculosis Complicated By Fungi Infection

Objective:To study the influencing factors and clinical features of pulmonary fungal infection of pulmonary tuberculosis applies references to the clinical diagnosis; In total of 173 bacteria from different clinical sources accompanied with yeast-like fungal infection have been identified strains of fungi and analyzed the drug resistant .It was used for instructing a reasonable clinical treatment.Method:39 cases of pulmonary tuberculosis with pulmonary fungal infection and 51 cases of tuberculosis patients without pulmonary fungal infection were collected from Handan city infectious disease hospital from January 2005 to December 2006. It was analyzed by case-control study. All subjects had been adopted in a unified manner of the questionnaire. The result was analyzed statistically with the SPSS software. The clinical samples of 173 patients with pulmonary fungal infections from HanDan had been identified strains of fungi and analyzed the drug resistance by ATB ID 32 C yeast identification system, ATB FUNGUS susceptibility boxes and ATB Express for automatic identification. 38 cases of pulmonary tuberculosis with yeast-like fungal infection were analyzed the drug resistance by ATB FUNGUS 2-Minka.Result:The result of case-control study showed that the influencing factors of pulmonary tuberculosis with pulmonary fungal infection had relationship with a medical history of tuberculosis, the secondary tuberculosis, the usage of antibiotics and glucocorticoid drugs and tubercle bacillus of sputum smear-negative of the five guide lines. The majority of the distribution fungus was Candida added up to 39 cases with pulmonary fungal infections, of which Candida albicans was 29 cases, (74.5%); Candida tropicalis was 3 cases, (7.7%); Candida parapsilosis was 3 cases, (7.7%); Candida krusei was 2 cases, (5.1%); It also kept one case of Monilia guilliermondii and one case of Aspergillus. 173 cases of yeast-like fungal fungus were collected , of which Candida albicans was 115 cases, (66.47%); Candida tropicalis was 34 cases, (19.65%); Candida parapsilosis was 11 cases,(6.36%); Candida krusei was 9 cases,(5.20%); Monilia guilliermondii was 1 case,(0.58%); unknown candidiasis was 1 case,(0.58%); other Candida was 2 case,(1.16%). The Candida albicans was higher rate of drug resistance, 56 cases(48.7%) of which were resistant to 5-fluorocytosine (5-FCT), amphotericinB(AMB), anticandine, miconazole,econazole, ketoconazole respectively.Conclusion: The influencing factors of pulmonary tuberculosis with pulmonary fungal infection had relationship with a medical history of tuberculosis,the secondary tuberculosis, the usage of antibiotics and glucocorticoid drugs and the tubercle bacillus of sputum smear-negative of the five guide lines. Most types of pulmonary tuberculosis with pulmonary fungal infection were Candida albicans. The resistance of Candida albicans to the fluconazole was the highest. Most clinical types of fungal infection of HanDan were also Candida albicans. The resistance of Candida albicans to the econazole was the highest.