艾滋病合并肺部感染患者痰液、血液和肺泡灌洗液中病原菌的检出率  

Detection rate of pathogens from sputum,blood,and bronchoalveolar lavage fluid samples in acquired immunodeficiency syndrome patients complicated with pulmonary infection

作　　者：田雅 王宇 王雅杰 陈晨[4] 陈振 王慧珠[3] 张福杰 Tian Ya;Wang Yu;Wang Yajie;Chen Chen;Chen Zhen;Wang Huizhu;Zhang Fujie(Savaid Medical School,University of Chinese Academy of Sciences,Beijing 100049,China;Clinical and Research Center of Infectious Diseases,Beijing Ditan Hospital,Capital Medical University,Beijing 100015,China;Department of Clinical Laboratory,Beijing Ditan Hospital,Capital Medical University,Beijing 100015,China;Institute of Infectious Diseases,Beijing Ditan Hospital,Capital Medical University,Beijing 100015,China)

机构地区：[1]中国科学院大学存济医学院,北京100049 [2]首都医科大学附属北京地坛医院感染病临床研究中心,100015 [3]首都医科大学附属北京地坛医院检验科,100015 [4]首都医科大学附属北京地坛医院传染病研究所,100015

出　　处：《中华传染病杂志》2019年第6期343-346,共4页Chinese Journal of Infectious Diseases

摘　　要：目的了解艾滋病合并肺部感染患者血液、痰液和肺泡灌洗液(bronchoalveolar lavage fluid,BALF)标本中病原菌的检出率。方法2018年2月至2018年9月于首都医科大学附属北京地坛医院住院的艾滋病合并肺部感染患者73例,收集患者血液、痰液和BALF标本。血液标本培养后检测厌氧菌、需氧菌、真菌和分枝杆菌,抗原凝集法检测隐球菌。痰液标本行抗酸染色检测结核分枝杆菌,痰培养检测细菌和真菌,显微镜下观察有无菌丝或孢子。BALF标本培养检测细菌和真菌,抗酸染色和PCR检测结核分枝杆菌,六胺银染色检测肺孢子菌,显微镜下观察有无菌丝或孢子。比较3种标本中病原菌的检出率。统计学分析采用χ^2检验。结果73例艾滋病合并肺部感染患者的血液、痰液和BALF标本中分别检出病原菌8份(11.0%)、23份(31.5%)和48份(65.8%),差异有统计学意义(F=48.513,P<0.01)。BALF标本病原菌检出率高于血液和痰液(χ^2分别为43.349和17.136,均P<0.01),痰液标本病原菌检出率高于血液(χ^2=9.215,P<0.05)。血液、痰液和BALF标本中检出率最高的病原菌分别是马尔尼菲篮状菌3份(4.1%)、甲型链球菌12份(16.4%)和甲型链球菌26份(35.6%)。结论艾滋病合并肺部感染患者BALF标本中病原菌检出率最高,其次为痰液,血液最低。Objective To study the detection rate of pathogens from sputum,blood,and bronchoalveolar lavage fluid(BALF)samples in acquired immunodeficiency syndrome(AIDS)patients complicated with pulmonary infection.Methods Seventy-three hospitalized AIDS patients complicated with pulmonary infection in Beijing Ditan Hospital,Capital Medical University were enrolled from February 2018 to September 2018.Blood,sputum and BALF samples were collected.Blood samples were cultured to detect anaerobic bacteria,aerobic bacteria,fungi and mycobacteria.Antigen agglutination method was applied in blood samples to detect cryptococcus neoformans.The sputum samples were tested for Mycobacterium tuberculosis by acid-fast staining and were cultured to detect bacteria and fungi.The sputum samples were observed under microscope for sporotrichosis and fungal spores.The BALF samples were cultured to detect bacteria and fungi.The BALF samples were tested for Mycobacterium tuberculosis by polymerase chain reaction amplification and acid-fast staining.Pneumocystis were detected in BALF samples by methenamine silver staining method.The BALF samples were observed under a microscope for sporotrichosis and fungal spores.The detection rate of pathogens from blood,sputum and BALF samples were compared.Chi-square test was conducted for statistical analysis.Results In 73 AIDS patients complicated with pulmonary infection,the pathogen detection rates in blood,sputum and BALF samples were 8(11.0%),23(31.5%)and 48(65.8%),respectively.The difference was statistically significant(F=48.513,P<0.01).The detection rate in BALF samples was significantly higher than that in blood or sputum samples(χ^2=43.349 and 17.136,respectively,both P<0.01).The detection rate in sputum samples was significantly higher than that in blood(χ^2=9.215,P<0.05).The highest detection rates of pathogens in blood,sputum and BALF samples were Talaromyces marneffei 4.1%(3),viridans group streptococci 16.4%(12)and 35.6%(26),respectively.Conclusions The detection rate of pathogens in BALF sa

关 键 词：获得性免疫缺陷综合征 肺部感染 病原诊断 

分 类 号：R44[医药卫生—诊断学]