Clinical manifestations and high risk factors of prognosis in 295 patients with invasive pulmonary fungal in-fection

MENG Lei; LIU Xiujuan; SHI Ming; ZHANG Meixiang; SUN Huifang; ZUO Zhigang; JIN Liang

doi:10.3969/j.issn.1673-3827.2025.04.008

Abstract：Objective To analyze the clinical manifestations and high risk factors of prognosis of 295 patients with invasive pulmonary fungal infection.Methods From November 2019 to July 2024,295 patients with invasive pulmonary fungal in-fection in Department of Critical Care Medicine,First Hospital of Qinhuangdao City were selected,and their clinical data were collected retrospectively.After treatment,244 patients survived and 51 patients died within 30 days.The clinical mani-festations and chest computerized scanning(CT)of patients with invasive pulmonary fungal infection were analyzed,prog-nostic risk factors were evaluated using logistic regression analysis.Results The clinical manifestations of 295 patients with invasive pulmonary fungal infection were mainly rales and fever in the lungs,accounting for more than 80%.The CT images of the chest were mainly patchy shadows and cavities,accounting for more than 30%.312 strains of pathogenic fungi isola-ted from 295 patients with invasive pulmonary fungal infection were mainly Candida albicans,C.tropicalis and Aspergil-lus,accounting for 49.04%,20.83%and 18.91%respectively.Multivariate logistic analysis showed that the high risk factors of prognosis of patients with invasive pulmonary fungal infection included acute kidney injury,mechanical ventilation,low level of peripheral blood Hb and low level of peripheral blood PLT(OR=1.679,1.353,1.952,1.384,P<0.05).Conclusion The clinical manifestations and chest CT of patients with invasive pulmonary fungal infection had no specific manifestations.The main pathogens were C.albicans,C.tropicalis and Aspergillus.The high-risk factors affecting the prognosis of patients with invasive pulmonary fungal infection mainly include acute kidney injury,mechanical ventilation,low level of peripheral blood Hb and low level of peripheral blood PLT.Therefore,targeted treatment and nursing measures could be adopted to intervene in high-risk patients.