Serological characteristics and susceptibility factors of pulmonary fungal infection in elderly chronic obstructive pulmonary disease patients
WANG Qing
LIU Yan
ZHANG Ting
WANG Xiao-xin
Abstract：Objective This study was to investigate the serological characteristics,flora distribution and related predisposition factors of secondary pulmonary fungal infection(PFI)in elderly patients with chronic obstructive pulmonary disease(COPD).Methods 443 elderly patients with acute exacerbation of COPD admitted to the Geriatrics Department of the First Affiliated Hospital of Air Force.Methods University from February 2021 to January 2024 were selected,including 291 males and 152 females,aged(69.13±5.61)years old,ranging from 60 to 85 years old.According to whether there is secondary PFI,it is divided into a secondary PFI group(n=54)and a non secondary PFI group(n=389).Analyze the distribution characteristics of microbiota in COPD secondary to PFI;collect clinical data and conduct univariate and multivariate analyses;evaluate the diagnostic value of predictor variables using receiver operating characteristic(ROC)curves.Results Among 54 COPD patients with secondary PFI,62 strains of bacteria were detected,mainly Candida infections,of which Candida albicans accounted for 48.4％.The multifactorial results showed that the alleviation of hypoalbuminemia was an independent protective factor for secondary PFI in elderly COPD patients(P＜0.05).The dosage of glucocorticoids,elevated levels of 1,3-beta-D glucan,galactomannan(GM),C-reactive protein,procalcitonin,and tumor necrosis factor-α are independent risk factors for secondary PFI in elderly COPD patients(P＜0.05).ROC analysis showed that the dosage of glucocorticoids,1,3-beta-D glucan,GM,C-reactive protein,procalcitonin,tumor necrosis factor-α,and combined prediction were statistically significant in predicting secondary PFI in elderly COPD patients(P＜0.05).The area under the curve of hypoalbuminemia is 0.558,with low predictive value(P＞0.05).Conclusion Reduced hypoalbuminemia is an independent protective factor for secondary PFI in elderly COPD patients;The dosage of glucocorticoids,elevated levels of 1,3-beta-D glucan,GM,C-reactive protein,procalcitonin,and tumor necrosis factor-α are independent risk factors for secondary PFI in elderly COPD patients,but their predictive value for hypoalbuminemia is relatively low.
Keywords：Chronic obstructive pulmonary diseaseSerological characteristicsPulmonary fungal infectionPredisposing factor
Publication Date：2025-05-25
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 198-203 )