ICU非HIV患者肺孢子菌定植情况分析

新发传染病电子杂志 ›› 2018, Vol. 3 ›› Issue (3): 167-170.

ICU非HIV患者肺孢子菌定植情况分析

胡水秀, 黄葵, 蓝争, 覃海园, 唐秀文

广西壮族自治区龙潭医院,广西柳州 545005

收稿日期:2018-05-10 出版日期:2018-08-31 发布日期:2020-06-30
通讯作者: 黄葵,Email：huangkui2@yeah.net

Pneumocystis jirovecii colonization in intensively cared patients with non-HIV infection

HU Shui-xiu, HUANG Kui, LAN Zheng, QIN Hai-yuan, TANG Xiu-wen

Guangxi zhuang autonomous region Longtan Hospital, Guangxi Liuzhou 545005, China

Received:2018-05-10 Online:2018-08-31 Published:2020-06-30

摘要/Abstract

摘要： 目的分析ICU非HIV感染患者肺部耶氏肺孢子菌（Pneumocystis jirovecii,P.jirovecii）定植情况,探讨P.jirovecii定植与不同疾病及CD4⁺T淋巴细胞数的相关性。方法选择2016年4月至2018年3月广西壮族自治区龙潭医院ICU经肺泡灌洗液(BALF)标本P.jirovecii检测阳性并确定为P.jirovecii定植的33例非HIV感染患者为P.jirovecii定植组,另选择同期P.jirovecii检测阴性的48例非HIV感染患者为P.jirovecii阴性组,对比分析两组患者不同临床特征与P.jirovecii定植的相关性。结果 81例患者中P.jirovecii定植率为40.7%。P.jirovecii定植组休克的发生率高于P.jirovecii阴性组（P<0.05）;P.jirovecii定植组重症肺炎的发生率高于P.jirovecii阴性组(P<0.05 );肺部肿瘤、间质性肺疾病（ILD）、慢性阻塞性肺疾病急性加重（AECOPD）及肺结核的发生率在P.jirovecii定植组与阴性组间差异均无统计学意义（P>0.05）。CD4⁺>400个/μl、CD4⁺400~200个/μl及CD4⁺<200个/μl三组患者P.jirovecii定植率分别为45.5%、35.0%及44.1%,差异无统计学意义（P>0.05）。结论 ICU非HIV患者P.jirovecii定植率较高。休克、重症肺炎与P.jirovecii定植具有相关性。肺部肿瘤、ILD、AECOPD肺结核与P.jirovecii定植无关。P.jirovecii定植与CD4⁺T淋巴细胞水平无关,可能受多因素影响。

关键词: 耶氏肺孢子菌, 定植, 非HIV感染, ICU

Abstract: Objective To investigate the prevalence of Pneumocystis jirovecii（P.jirovecii）colonization in patients admitted into ICU with non-HIV infection, and to explore the correlationship between P.jirovecii colonization and occurrence of various diseases as well as CD4⁺T cell count. Methods A total of 33 non-HIV-positive patients with P.jirovecii positive identified in bronchoalveolar lavage fluid (BALF) specimen and confirmed as colonization in intensive care unit (ICU) in our hospital from April 2016 to March 2018 were chosen as the subjects of the P.jirovecii colonization group. Meanwhile,48 non-HIV-positive patients with P.jirovecii negative were selected as the control. The clinical data of the two groups were analyzed. Results The colonization rate of P.jirovecii was 40.7% in 81 patients. The incidence of shock in the P.jirovecii colonization group was significantly higher than that in the P.jirovecii negative group(P<0.05). The incidence of severe pneumonia in the P.jirovecii colonization group was significantly higher than that in the P. jirovecii negative group（P<0.05). No statistical differences were found concerning the incidences of pulmonary malignanttumor, interstitial lung disease (ILD), acute exacerbation of chronic obstructive pulmonary disease (AECOPD), and pulmonary tuberculosis between the P.jirovecii colonization group and the P. jirovecii negative group (P>0.05). The incidences of P.jirovecii colonization was 45.5%, 35.0% and 44.1% in the groups of CD4⁺>400 cells/μl, CD4⁺ 400~200 cells/μl and CD4⁺<200 cells/μl, respectively, with no statistical significance between the three groups (P>0.05). Conclusion The colonization rate of P.jirovecii is high in intensively cared non-HIV-positive patients. Shock and severe pneumonia more commonly occur in patients with P.jirovecii colonization. The occurrences of pulmonary malignant tumor, ILD, AECOPD, and pulmonary tuberculosis are not related to P.jirovecii colonization. And the occurrence of P.jirovecii colonization is not related to CD4⁺T cell count.

Key words: P.jirovecii, Colonization, Non-HIV positive, ICU

胡水秀, 黄葵, 蓝争, 覃海园, 唐秀文. ICU非HIV患者肺孢子菌定植情况分析[J]. 新发传染病电子杂志, 2018, 3(3): 167-170.

HU Shui-xiu, HUANG Kui, LAN Zheng, QIN Hai-yuan, TANG Xiu-wen. Pneumocystis jirovecii colonization in intensively cared patients with non-HIV infection[J]. Electronic Journal of Emerging Infectious Diseases, 2018, 3(3): 167-170.

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