Risk factors of pulmonary fungal infection in patients with pulmonary tuberculosis: a meta-analysis
HUANG Guo-jun1, GAO Xiao2, TANG Xi-liang1, YIN Shi-lin3, BAI Li-qiong1
1. Hunan Institute for Tuberculosis Control, Hunan Chest Hospital, Changsha, Hunan 410013, China; 2. Department of Preventive Medicine, School of Medicine, Hunan Normal University, Changsha, Hunan 410013, China; 3. Xiangya School of Public Health, Central South University, Changsha, Hunan 410078, China
Abstract:Objective To systematically review the main risk factors of pulmonary fungal infection in patients with pulmonary tuberculosis. Methods Literatures about pulmonary fungal infection in patients with pulmonary tuberculosis were retrieved from CNKI, VIP, Wanfang and PubMed from their establishment to February 28, 2020. Two researchers independently screened theliteratures according to the inclusion and exclusion criteria, extracted the data and evaluated the quality. The meta-analysis was performed by Stata12.0. Results A total of 16 studies were included in the final analysis. The meta-analysis showed that patients aged 60 years and above (OR=4.51, 95%CI:1.85-10.96), duration of disease more than or equal to 5 years (OR=4.32, 95%CI:3.04-6.14), retreated pulmonary tuberculosis (OR=5.82, 95%CI: 3.08-11.00), number of lesion more than or equal to 3 pulmonary fields (OR=2.82, 95%CI: 2.33-3.42), having pulmonary cavity (OR=3.44, 95%CI: 2.06-5.75), complicated with diabetes (OR=2.05, 95%CI: 1.75-2.42), invasive procedures (OR=6.42, 95%CI: 4.54-9.08), long-term use of broad-spectrum antibiotics (OR=4.52, 95%CI:1.79-11.39), long-term use of glucocorticoids (OR=3.74, 95%CI:2.26-6.19) and sputum smear positive (OR=0.49, 95%CI: 0.28-0.87) were associated with the development of pulmonary fungal infection in patients with pulmonary tuberculosis, but there was no significant association between gender and the development of pulmonary fungal infection in patients with pulmonary tuberculosis (P=0.066). Conclusion The main risk factors of pulmonary fungal infection in patients with pulmonary tuberculosis are advanced age, long-term course of disease, retreated pulmonary tuberculosis, wide range of pulmonary lesion, having pulmonary cavity, complicated with diabetes, invasive procedures, long-term use of broad-spectrum antibiotics and long-term use of glucocorticoids.
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