2015至2020年北京地区住院艾滋病患者临床分离菌的菌种分布及其耐药性分析  

Analysis on distribution and drug resistance of pathogens isolated from acquired immunodeficiency syndrome inpatients in Beijing from 2015 to 2020

作　　者：马小艳[1] 徐新民[1] 李瑞红[1] 李敏[1] 张燕[1] 王慧珠[1] Ma Xiaoyan;Xu Xinmin;Li Ruihong;Li Min;Zhang Yan;Wang Huizhu(Department of Clinical Laboratory,Beijng Ditan Hospital,Capital Medical University,Beijing 100015,China)

机构地区：[1]首都医科大学附属北京地坛医院检验科,北京100015

出　　处：《药物不良反应杂志》2021年第12期617-623,共7页Adverse Drug Reactions Journal

摘　　要：目的了解北京地区近年来住院艾滋病患者临床分离菌的菌种分布及其耐药状况。方法收集首都医科大学附属北京地坛医院2015年1月—2020年12月住院艾滋病患者临床分离菌株的菌种鉴定和抗菌药物敏感性(药敏)试验相关资料进行描述性回顾分析。结果纳入分析的菌株为728株,主要分离自血标本(292株,40.1%)、支气管灌洗液标本(116株,15.9%)、痰标本(114株,15.7%)、尿液标本(83株,11.4%)、骨髓标本(26株,3.6%)、脑脊液标本(24株,3.3%)和胸腔积液标本(24株,3.3%)等。728株临床分离菌中,革兰阴性杆菌235株(32.3%),主要为铜绿假单胞菌、大肠埃希菌、沙门菌属和鲍曼不动杆菌;革兰阳性球菌162株(22.3%),主要为凝固酶阴性葡萄球菌和金黄色葡萄球菌;分枝杆菌139株(19.1%),为结核分枝杆菌和非结核分枝杆菌;真菌108株(14.8%),主要为新型隐球菌和马尔尼菲篮状菌;其他病原菌84株(11.5%)。按单一菌种计,占比居前5位者依次为结核分枝杆菌、凝固酶阴性葡萄球菌、非结核分枝杆菌、铜绿假单胞菌和大肠埃希菌。与同医院2009—2014年艾滋病患者临床分离菌的菌种分布情况比较,革兰阴性杆菌的占比有所下降(2009—2014年为40.73%),革兰阳性球菌、真菌和结核分枝杆菌的占比大致相似(2009—2014年分别为19.15%、14.02%和9.27%),但非结核分枝杆菌的占比明显增加(2009—2014年因占比较低未单独计算而归为其他,其他占比为6.34%)。革兰阴性杆菌多分离自呼吸道标本(47.2%,111/235),其次是尿液标本(20.4%,48/235);革兰阳性球菌多分离自血标本(45.7%,74/162),其次是骨髓标本(13.0%,21/162);分枝杆菌主要分离自血标本(72.7%,101/139),其次是呼吸道标本(26.6%,37/139);真菌主要分离自血标本(44.4%,48/108),其次是呼吸道标本(19.5%,21/108)和脑脊液标本(17.6%,19/108)。药敏试验结果显示,与同医院2009—2014年艾滋病患者临床分离菌的耐药情况比较,革Objective To understand the distribution and drug resistance of pathogens isolated from acquired immunodeficiency syndrome(AIDS)inpatients inBeijing areain recent years.Methods The data on strain identification and antimicrobial susceptibility tests of clinical isolates of pathogens from AIDS inpatients in Beijing Ditan Hospital,Capital Medical University between January 2015 and December 2020 were collected and analyzed descriptively and retrospectively.Results A total of 728 strains of pathogens were included in the analysis,mainly isolated from blood samples(292 strains,40.1%),bronchial lavage fluid samples(116 strains,15.9%),sputum samples(114 strains,15.7%),urine samples(83 strains,11.4%),bone marrow samples(26 strains,3.6%),cerebrospinal fluid samples(24 strains,3.3%),and pleural effusion samples(24 strains,3.3%).Among the 728 pathogenic strains,235(32.3%)were Gram-negative bacilli,mainly including Pseudomonas aeruginosa,Escherichia coli,Salmonella spp.,and Acinetobacter baumannii;162(22.3%)were Gram-positive cocci(22.3%),mainly including coagulase negative staphylococci and Staphylococcus aureus;139(19.1%)were mycobacteria,including Mycobacterium tuberculosis and nontuber-culous mycobacteria;108(14.8%)were fungi,mainly including Cryptococcus neoformans and Talaromyces marneffei;84(11.5%)were other pathogenic strains.According to the calculation of single strain,the top 5 pathogenswereMycobacterium tuberculosis,coagulase negative staphylococcus,nontuberculous mycobacteria,Pseudomonas aeruginosa,and Escherichia coli suceesively.In comparison with the distribution of pathogens isolated from AIDS patients in the same hospital in 2009-2014,the proportion of Gram-negative bacilli decreased(40.73%from 2009 to 2014),and the proportions of Gram-positive cocci,fungi,and Mycobacterium tuberculosis were similar(19.15%,14.02%,and 9.27%respectively in 2009-2014),and the proportion of non tuberculosis mycobacteria increased significantly(it was not calculated separately and classified into'others'because of the relativel

关 键 词：HIV 获得性免疫缺陷综合征 细菌感染 耐药 细菌 

分 类 号：R512.91[医药卫生—内科学] R446.5[医药卫生—临床医学]