Risk factors of acquired pulmonary fungal infection in acute exacerbation of chronic obstructive pulmonary disease

Shi Weixia; Lin Yingxiang; Zhu Jianguo; Xiao Huanbo

doi:10.3760/cma.j.issn.1673-4777.2016.01.008

Abstract：Objective To investigate the risk factors of acquired pulmonary fungal infection in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).Methods Clinical data of 794 hospitalized patients with AECOPD from January to December 2011 were retrospectively analyzed.The patients divided into acquired fungal infection group (140 cases) and non-secondary fungal infection group (654 cases).Single factor and multi-factor non-conditional logistic regression analysis were used to analyze 20 risk factors of acquired fungal infection.Results Single factor non-conditional logistic regression analysis showed that the history of fungal infection, hypoalbuminemia, respiratory failure, renal insufficiency, hospitalization stay, length of intensive care unit stay, intravenous catheters, nasogastric tube, indwelling of bladder catheters, peripheral intravenous nutrition, non-invasive and invasive mechanical ventilation, duration of hormone application, duration and type of antibiotics were risk factors of secondary fungal infection (P ＜ 0.05).These associated risk factors then entered into multi-factor logistic regression analysis, which showed that the previous history of fungal infection, duration of hormone application ＞ 2 weeks, duration of antibiotic application ＞ 2 weeks, invasive mechanical ventilation, venous catheters and type of antibiotics ＞ 2 were the main risk factors of acquired fungal infection (odds ratio : 63.319, 3.193, 1.691, 1.615, 2.002, 2.040, P＜0.05).Conclusion Previous history of fungal infection, long-term application of hormone, application of invasive mechanical ventilation, long-term application of multiple antibiotic and central venous catheter indwelling are the main risk factors of acquired fungal infection in patients with AECOPD.