Rafat Zahra, Hashemi Seyed Jamal, Ashrafi Keyhan, Nikokar Iraj, Jafari Alireza, Rahimi Foroushani Abbas, Roohi Behrad, Borjian Boroujeini Zeinab, Rashidi Niloofar, Najar-Shahri Niki
Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Food Microbiology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
J Multidiscip Healthc. 2020 Jul 22;13:661-669. doi: 10.2147/JMDH.S252371. eCollection 2020.
Fungal respiratory infections are being recognized with increasing frequency in parallel with an expanding population of immunocompromised patients. In most cases, colonization is the first step in the progression to pulmonary fungal infection. This study was designed to evaluate the distribution of fungal elements in the respiratory tract of symptomatic patients hospitalized in pulmonary units.
This descriptive cross-sectional study was carried out over a period of two years, from October 2017 to October 2019 in Guilan province, located in Iran's northern region. In the current study, bronchoalveolar lavage or sputum specimens were collected. All samples were analyzed by direct microscopy using KOH 10% and culture. Fungal identification was accomplished by internal transcribed spacer (ITS) and beta-tubulin sequencing. Also, in patients suspected of invasive pulmonary aspergillosis, BAL specimens were tested for galactomannan (GM) antigen.
A total of 384 lung specimens (192 bronchoalveolar lavage (BAL) and 192 sputum samples) were obtained from symptomatic patients hospitalized in pulmonary units. Of these, 137 (35.67%) were positive in direct examination and culture. Among the 137 positive cases, most isolates were from male patients 86 (62.77%) and most of them were between 46 and 72 years. (37.22%) and (21.89%) represent the two most commonly isolated species in the current study. Cough (94.16%), dyspnea (81.02%), purulent sputum (62.04%) and weight loss (56.2%) were the predominant symptoms and tuberculosis (24.81%), chemotherapy (21.89%) and diabetes mellitus (19.70%) were the predominant underlying conditions. Also, 5 cases of invasive pulmonary aspergillosis and 1 case of mucormycosis were diagnosed.
was the most common fungal species isolated from symptomatic patients hospitalized in pulmonary units. Tuberculosis, chemotherapy and diabetes mellitus were important underlying conditions for pulmonary fungal colonization and/or infection.
随着免疫功能低下患者群体的不断扩大，真菌性呼吸道感染的确诊频率日益增加。在大多数情况下，定植是进展为肺部真菌感染的第一步。本研究旨在评估入住肺部疾病科室的有症状患者呼吸道中真菌成分的分布情况。
本描述性横断面研究于2017年10月至2019年10月在伊朗北部地区的吉兰省进行，为期两年。在本研究中，收集支气管肺泡灌洗或痰液标本。所有样本均采用10%氢氧化钾直接显微镜检查和培养进行分析。通过内转录间隔区（ITS）和β-微管蛋白测序完成真菌鉴定。此外，对疑似侵袭性肺曲霉病的患者，检测支气管肺泡灌洗标本中的半乳甘露聚糖（GM）抗原。
从入住肺部疾病科室的有症状患者中总共获取了384份肺部标本（192份支气管肺泡灌洗标本和192份痰液样本）。其中，137份（35.67%）在直接检查和培养中呈阳性。在这137例阳性病例中，大多数分离株来自男性患者86例（62.77%），且大多数患者年龄在46至72岁之间。（37.22%）和（21.89%）是本研究中最常分离出的两种真菌。咳嗽（94.16%）、呼吸困难（81.02%）、脓性痰（62.04%）和体重减轻（56.2%）是主要症状，结核病（24.81%）、化疗（21.89%）和糖尿病（19.70%）是主要基础疾病。此外，诊断出5例侵袭性肺曲霉病和1例毛霉病。
是从入住肺部疾病科室的有症状患者中分离出的最常见真菌种类。结核病、化疗和糖尿病是肺部真菌定植和/或感染的重要基础疾病。
