雅温得地区引起下呼吸道感染的真菌病原体敏感性分析

Claris K, Laure N, Leopold N, Ekobo S, Hortense G
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引用次数: 0

摘要

背景:呼吸道传染病被称为呼吸道感染(respiratory tract infections, RTIs)。这种类型的感染通常进一步分为上呼吸道感染(URI或URTI)或下呼吸道感染(LRI或LRTI)。小呼吸道感染是所有传染病中导致死亡的主要原因。本研究的目的是了解雅温得地区导致下呼吸道感染的真菌病原体的敏感性。方法:我们在雅温得Jamot医院进行了为期6个月(2021年2月至6月)的横向描述性研究。本研究纳入医生要求进行痰液或支气管肺泡液分析的下呼吸道感染患者,对样本进行宏观、显微镜、真菌培养,阳性培养物进行菌管试验、真菌敏感性试验和id32c库鉴定,采用R版本3.6.1软件进行统计分析。通过Kruskal - Wallis秩和检验计算平均值。结果:300例患者参与本研究。平均年龄±标准差为41.59±17.5岁,四肢分别为1岁和91岁。阳性真菌感染127例(42.33%),其中白色念珠菌75例(59%),隐球菌25例(19.68%),热带念珠菌10例(7.87%),克氏念珠菌6例(4.72%),famata念珠菌4例(3.14%),清酒念珠菌4例(3.14%),弯曲隐球菌3例(2.36%)。抗真菌类药物的总敏感性依次为奈他汀(98.47%)、两性霉素B(86.91%)、咪康唑(55.42%)、Econazole(52.61%)、酮康唑(52.57%)、氟康唑(14.42%)。真菌致病菌检出率为42.33%。300例患者中,结核71例,艾滋病阳性24例,糖尿病6例,艾滋病合并结核合并感染5例,艾滋病合并真菌感染16例,艾滋病合并结核合并感染6例。结论:本研究显示真菌病原菌在呼吸道的定殖率较高(42.33%)。引起下呼吸道感染的真菌病原体有白色念珠菌、热带念珠菌、克鲁氏念珠菌、famata念珠菌、sake念珠菌、humicola隐球菌和弯曲隐球菌。首选药物是奈他汀,氟康唑的活性非常有限。应在其他城镇进行进一步研究,以便更好地记录喀麦隆的这一问题。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Sensitivity Profile of Fungal Pathogens Responsible for Lower Respiratory Tract Infections in Yaounde
Background: Infectious diseases of the respiratory tract are known as respiratory tract infections (RTIs). An infection of this type usually is further classified as an upper respiratory tract infection (URI or URTI) or a lower respiratory tract infection (LRI or LRTI). LRIs are the leading cause of death among all infectious diseases. The objective of our study was to bring out the sensitivity profile of fungal pathogens responsible for lower respiratory tract infections in Yaounde Methods: We carried out a transverse and descriptive study during a 6 month period (February to June 2021), at the Jamot hospital in Yaounde. Included in this study were patients suffering from a lower respiratory tract infection from whom the medical practitioner had requested a sputum or broncho alveolar liquid analysis A macroscopic, microscopic, fungal culture of the sample was carried out and a germ tube test, fungal sensitivity test as well as specie identification using the ID 32 C gallery was carried out on the positive cultures Statistical analysis was carried out using the R version 3.6.1 software. The mean was calculated with the aid of the Kruskal Wallis rank sum test. Results: 300 patients participated in this study. They had mean age ± standard deviation of 41.59 ± 17.5 years and extremities of 1 and 91years. The male /female ratio was 2:1 Fungal infection was positive in 127 patients (42.33 %), 75 (59%) Candida albicans, 25 (19.68%) Cryptococcus humicola, 10 (7.87%) Candida tropicalis, 6 (4.72%) Candida krusei, 4 (3.14%) Candida famata, 4 (3.14%) Candida sake and 3 (2.36%) Cryptococcus curvatus. As far as antifungigram is concerned, the total drug susceptibility was Nystatine (98.47%), Amphotericine B (86.91%), Miconazole (55.42%), Econazole (52.61%), Ketoconazole (52.57%) and Fluconazole (14.42%).The prevalence of fungal pathogens was 42.33%. Of the 300 patients, 71 had tuberculosis, 24 were HIV positive and 6 were diabetic we had 5 patients with HIV, tuberculosis and fungal co-infection, 16 with HIV and fungal co-infection and 6 with HIV and tuberculosis co-infection. Conclusion: This study shows a relative high prevalence (42.33%) of the colonization of the respiratory tract by fungal pathogens. The fungal pathogens responsible for lower respiratory tract infections are Candida albicans, Candida tropicalis, Candida krusei, Candida famata, Candida sake, Cryptococcus humicola and Cryptococcus curvatus. The drug of choice is Nystatine and Fluconazole presents a very limited activity. Additional studies should be carried out in other towns in order to better document this issue in Cameroon.
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