Clinical features and risk factors of pulmonary tuberculosis complicated by fungal infection
ZHANG Haiyan1 ZHANG Cai1 FAN Hui2▲
1.Department of Infectious Diseases,Rugao Hospital Affiliated to Nantong University
2.Department of Oncology,Rugao Hospital Affiliated to Nantong University
Abstract：Objective To investigate the clinical characteristics and risk factors of pulmonary tuberculosis complicated by fungal infection.Methods The clinical data of 104 pulmonary tuberculosis patients admitted to Rugao Hospital Affiliated to Nantong University from January 2017 to December 2020 were retrospectively analyzed.All the selected subjects were cultured with Aspergillus,and the patients were divided into infection group (n=25) and non-infected group (n=79) according to the culture results.The clinical data of the two groups were counted,the clinical characteristics and risk factors of fungal infection were analysed.Results The results of Aspergillus culture showed that of the 104 pulmonary tuberculosis patients,25 cases had fungal infection,the incidence was 24.04% (25/104).The most common clinical manifestations of 25 pulmonary tuberculosis patients with fungal infection were cough and sputum (100.00%),followed by hemoptysis (72.00%),fever (36.00%),chest pain (16.00%),dyspnea (4.00%).The proportion of hospitalization times＞2 times,repeated application of broad-spectrum antibiotics,long-term application of glucocorticoid and chronic obstructive pulmonary disease in the infection group were higher than those in the non infection group,the differences were statistically significant (P＜0.05).There were no statistically significant differences between the two groups in gender,age,body weight,smoking history and diabetes (P＞0.05).Logistic multivariate regression analysis showed that proportion of hospitalizations ＞2 times (β=1.626,OR =5.083,95% CI =1.951 -13.242),repeated use of broad-spectrum antibiotics (β=2.026, OR=7.585,95%CI=2.814-20.444),long-term use of glucocorticoids (β=1.357, OR=3.886,95%CI=1.519-9.942),combined with chronic obstructive pulmonary disease (β=2.094, OR=8.120,95%CI=2.945-22.387) were independent risk factors for pulmonary tuberculosis complicated with fungal infection.Conclusion The proportion of hospitalizations＞2 times,repeated use of broad-spectrum antibiotics,long-term use of corticosteroids,and chronic obstructive pulmonary tuberculosis patients are more likely to be infected with fungal.The clinical needs of patients with high-risk factors need to be paid close attention to in order to improve the prognosis.
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