Risk Factors And Clinical Outcomes Of Fungal Infections Of Lung

Objective: In resent years, the incidence of fungal infections has been elevating dramatically with the enlarging number of immunodeficiency hosts due to Acquired Immunodeficiency Syndrome (AIDS) and other diseases. Because of it's symptoms'nonspecificity and clinical manifestations'variousity, fungal infections'diagnosis is very difficult, especially the diagnosis for fungal infections of lung, on whith the researches are few. On the other hand, the antifungal drugs have a some severe side reaction and an inaccurate curative effect. As a result, fungal infections have been one of the main reasons that leaded to the immunodeficiency hosts'death of secondary infections. Therefore, to investigate the risk factors for fungal infections of lung and the factors related with it's poor prognosis is vital to the decreasement of it's incidence and the improvement of it's therapy. This study aimed to observe the factors so as to offer therapy support for clinical workers. Methods: The data of 21 cases of fungal infections of lung were analyzed from Oct,2003 to Dec,2004 in the 2nd Hospital of He Bei Medical University; 33 cases of hospital acquired infections were collected as control. T test, chi-square test and Logistic regression analysis were used for statistics. The factors to be investigated include age, ward, primary disease, antibiotic used, mechanical ventilation or not, mixed infection or not, a long time using hormone or not, the GNA score, the serum albumin and prognosis. Results: According to univariate analysis, the factors associated with the development of fungal infections of lung were age, GNA score, RCU ward, patients with Chronic Obstructive Pulmonary Disease(COPD ) , mechanical ventilation, mixed infection, a long time using hormone, hypoproteinemia, previous III cephalosporins and macrolides and fluoroquinolone and imipenem/meropenem use. Multivariate Logistic regression analysis identified two independent factors: high GNA score ( which means malnutrition ) and hypoproteinemia. Of 21cases of fungal infections of lung, 12 died, 9 survived. Univareate analysis revealed that age, GNA score, mechanical ventilation, a long time using hormone, hypoproteinemia were associated with clinical ptognosis. But according to multivariate Logistic regression analysis, only hypoproteinemia was a predictive factor. Conclusions: GNA score and hypoproteinemia were independent factors for fungal infections of lung.Hypoproteinemia was a predictive factor for the prognosis of fungal infections of lung.