广州地区HIV/AIDS合并肺部感染病原谱分析  

Pathogen spectrum of HIV/AIDS patients with pulmonary infection in Guangzhou

作　　者：林智猛 陈万山[1] 林连升[1] 胡凤玉[1] 张复春[1] 岑玉文[1] 

机构地区：[1]广州医科大学附属广州市第八人民医院传染病研究所,广东广州510060

出　　处：《热带医学杂志》2015年第12期1675-1678,共4页Journal of Tropical Medicine

基　　金：国家自然科学基金(81072729);国家卫生和计划生育委员会感染病临床重点专科建设项目(2013-2014)

摘　　要：目的探讨广州地区人类免疫缺陷病毒/获得性免疫缺陷综合征(HIV/AIDS)合并肺部感染患者的病原体分布特征,为临床诊断提供依据。方法收集121例HIV/AIDS肺部感染患者,经纤维支气管镜取肺泡灌洗液(BALF)标本涂片、培养,取肺组织(TBB)标本进行病理学检测,阳性标本进行回顾性分析。结果共检出细菌71例(41.8%),分支杆菌19例(11.2%),真菌54例(31.8%),耶氏肺孢子菌21例(12.4%),巨细胞病毒5例(2.9%)。细菌中以革兰阳性菌为主,分支杆菌中以结核分枝杆菌为主,真菌以马尔尼菲青霉菌为主。肺部单一病原感染23例(25.3%),多重感染68例(74.7%),多重感染主要发生在CD4+T淋巴细胞计数(CD4)≤200/μl患者中。结论广州地区HIV/AIDS患者肺部感染病原体主要为细菌和真菌,细菌以革兰阳性菌为主,条件致病菌居多,真菌以马尔尼菲青霉菌最为常见。CD4≤200/μl患者肺部多重病原感染现象严重。Objective To explore the characteristics of pathogens in HIV/AIDS patients with pulmonary infection in Guangzhou so as to provides some basis for clinical diagnosis and treatment. Methods Bronchoscopy was conducted to HIV/AIDS patients with pulmonary infection. The results of bronchoallveoar lavage fluid（BALF）test and transbronchial biopsy（TBB）were analyzed. Results 71 cases of bacteria（41.8%）,19 cases of mycobacterium（11.2%）,54 cases of fungi（31.8%）,21 cases of pneumocystis jirovecii（12.4%）and 5 cases of cytomegalovirus（2.9%）were detected. The major bacterial cases are grampositive bacteria,The major mycobacterium cases are mycobacterium tuberculosis,The major fungal cases are penicillium marneffeis. Monopathogenic infection in lungs were detected in 23 cases（25.3%） and mixed infection in 68 cases（74.7%）,most of the mixed infection cases are patients with CD4＋T-lymphocyte level（CD4）≤ 200/μl. Conclusions The major pathogenics are bacteria and fungi in HIV/AIDS patients with pulmonary infection in Guangzhou. The major bacterial cases are gramnegative bacteria mainly with conditional pathogenic bacteria,penicillium marneffeis have the largest number among the fungi.Patients who CD4≤200/μl are high-risk group to have mixed infection in lung.

关 键 词：HIV/AIDS 肺部感染 病原谱 

分 类 号：R563[医药卫生—呼吸系统]