Drug resistance and pathogenic spectrum of patients coinfected with nontuberculous mycobacteria and human-immunodeficiency virus in Chengdu, China  

作　　者：Dong-Mei Wang Yi Liao Qing-Feng Li Ma Zhu Gui-Hui Wu Yuan-Hong Xu Jing Zhong Jia Luo Ying-Jie Li 

机构地区：[1]Department of Clinical Laboratory, Public Health Clinical Center of Chengdu, Chengdu, Sichuan 610066, China [2]Department of Clinical Laboratory, Chengdu Woman's and Children's Central Hospital, Chengdu, Sichuan 610073, China

出　　处：《Chinese Medical Journal》2019年第11期1293-1297,共5页中华医学杂志（英文版）

摘　　要：Background:Human-immunodeficiency virus (HIV) infection is increasing worldwide and nontuberculous mycobacteria (NTM) is an established microbiologic cause of pulmonary disease,lymphadenitis,and disseminated disease in cases of advanced immune suppression.Data on patients coinfected with HIV and NTM are limited.Thus,this study aimed to analyze the clinical characteristics,drug resistance,and pathogen spectrum of patients coinfected with both HIV and NTM in the Chengdu area of China.Methods:Data of 59 patients coinfected with both HIV and NTM collected from the Public Health Clinical Center of Chengdu,between January 2014 and December 2018,were analyzed.NTM drug sensitivity testing was performed using the microporous plate ratio method.Data were analyzed using SPSS 19.0,and the change in drug resistance rate was analyzed using the chi-square (x2) test.Results:Seven species/complex of NTM were identified from patients coinfected with HIV and NTM in this study,with Mycobacterium avium-intracellulare complex (52.5%) and M.kansasii (27.1%) as the predominant species.Male patients were more affected 50/59 (84.7%);the mean age of the 59 cases was 45 years.The clinical characteristics mainly included anemia (86.4%),cough and expectoration (79.7%).The baseline CD4 count was <50 cells/μL (84.7%).Patients were mainly in advanced acquired immunodeficiency syndrome (AIDS) stage.Chest imaging mainly showed patchy shadows (42.4%) and nodules (32.2%),with various degrees of AIDS-defining diseases.The drug resistance of NTM was severe,and the rate of isoniazid resistance (100.0%) was the highest,followed by rifampicin (94.9%),streptomycin (94.9%),ofloxacin (93.2%),and others.Ethambutol (52.5%) and clarithromycin (33.9%) were relatively low.No significant difference was found in the drug resistance rate of NTM strain against nine antituberculosis drugs in 5 years (P > 0.05).Condusions:The immune level of patients coinfected with HIV and NTM is low in advanced AIDS stage;more male are affected in patients who are mainly infected w

关 键 词：Clinical features DRUG resistance HIV MYCOBACTERIUM avium-intracellulare infection MYCOBACTERIUM kansasii Nontuberculous MYCOBACTERIA 

分 类 号：R[医药卫生]