长沙地区AIDS合并菌血症患者病原菌分布及耐药性  

Distribution and drug-resistance of pathogens isolated from AIDS patients with bacteremia in Changsha

作　　者：易璨珺[1,2] 苏丽君[1] 邹海蛟[1] 王留杰[1] 左亚婵[1] 林雪迟[1] 沈晖 

机构地区：[1]长沙医学院临床微生物学与免疫学教研室,湖南长沙410219 [2]黄沙坪铅锌矿医院,湖南郴州424421 [3]长沙市第一医院,湖南长沙410005

出　　处：《长沙医学院学报》2013年第1期1-4,共4页Journal of Changsha Medical University

摘　　要：目的探讨艾滋病(获得性免疫缺陷综合征,AIDS)合并菌血症患者病原菌分布及其耐药性,为临床诊疗提供参考。方法对2009年1月—2010年12月某院住院患者送检标本中所有AIDS患者的血培养病原菌及其药敏资料进行回顾性分析,并与同期普通患者血培养病原菌资料进行比较。结果调查期间共收集9554份血培养标本(其中AIDS患者标本1522份),普通患者血培养阳性571份,AIDS患者血培养阳性77份。AIDS患者血培养病原菌主要以真菌为主(81.82%),其中马内菲青霉菌占66.23%,其次是新生隐球菌(7.79%)、克鲁维酵母菌(5.19%),细菌感染(18.18%)以散发病例为主;普通患者血培养病原菌主要以细菌为主(91.42%),真菌占8.58%;两组患者菌血症感染病原菌差异有统计学意义(χ2=254.55,犘<0.01)。马内菲青霉菌对两性霉素B、氟康唑敏感性差;而新生隐球菌、克鲁维酵母菌对抗真菌药物的敏感性较高,无明显耐药。结论加强AIDS合并菌血症患者机会致病菌的流行病学监测,及早发现病原菌,是实现感染控制的关键。Objective To evaluate the distribution and drug-resistance of pathogens isolated from acquired immunodeficiency syndrome(AIDS) patients with bacteremia, so as to provide reference for clinical diagnosis and treatment. Methods The isolation and drug. susceptibility of pathogens in blood culture of AIDS patients who were hospitalized between January 2009 and December 2010 were analyzed retrospectively, and compared with blood culture result of other patients during the same hospitalization period. Results A total of 9554 blood specimens were collected 1522 of which were from AIDS patients, 77 blood specimens from AIDS patients and571 from the other patients were positive for bolld culture. The main isolated pathogens in AIDS patients were fungi(81.82%), the isolation rate of Penicillium marneffei, Cryptococcus neoformans, and Kluyveromyces marxianus was 66.23%, 7.79%, and 5.19% respectively, bacterial infection was sporadic(18.18%); the major pathogens in blood culture of the other patients was bacteria(91.42%), while fungi was 8.58%; the difference in pathogens in blood culture between two groups was sigenificant(χ2=254.55.P<0.01). Penicillium marneffei exhibited low sensiticity to amphotericin B and fluconazole, while Cryptococcus neoformans and Kluyveromyces marxianus were sensitive to antifungal agents. Conclusion The key to the control of in AIDS patients with bacteremia is to strengthen epidemiological survey and find pathogens as soon as possible.

关 键 词：艾滋病 获得性免疫缺陷综合征 菌血症 病原菌 真菌感染 抗药性 微生物 

分 类 号：R512.91[医药卫生—内科学]