艾滋病患者细菌性血流感染病原菌分布及耐药情况  

Pathogen Distribution and Antimicrobial Susceptibility of Bacterial Bloodstream Infection in AIDS Patients

作　　者：田波 刘俊 李海雯 宋炜[2] 陈海云 孙建军[2] TIAN Bo;LIU Jun;LI Haiwen;SONG Wei;CHEN Haiyun;SUN Jianjun(The Third People’s Hospital of Kunming/Yunnan Clinical Medical Center for Infectious Diseases,Kunming Yunnan 650041;Dept.of Infection and Immunity,Shanghai Public Health ClinicalCenter,Shanghai 201508,China)

机构地区：[1]昆明市第三人民医院/云南省传染性疾病临床医学中心,云南昆明650041 [2]上海市公共卫生临床中心,上海201508

出　　处：《昆明医科大学学报》2022年第6期140-146,共7页Journal of Kunming Medical University

基　　金：云南省科技厅地方高校应用基础研究联合专项基金资助项目(202001BA070001-194);上海市公共卫生临床中心临床院内课题(KY-GW-2020-30)。

摘　　要：目的了解艾滋病住院患者细菌血流感染的患病率、病原菌种类及耐药情况。方法回顾性收集上海市公共卫生临床中心2015年至2020年血培养分离出细菌的艾滋病患者资料,分析病原菌种类及相应抗菌药物的耐药情况多重耐药的比例。结果艾滋病患者中2015年至2020年间血流感染细菌检出率为4.48%。革兰阳性菌检出128株(59.3%),83株有耐药报告,对青霉素的耐药率为94%,对红霉素的耐药率为91.4%,未检出利奈唑胺、替加环素、万古霉素、喹奴普汀/达福普汀耐药者,多重耐药率38.6%,39.7%的细菌对5类以上抗菌药耐药。革兰阴性菌检出88株(40.7%),70株有耐药报告,对氨苄西林的耐药率为81.6%,喹诺酮类、碳青霉烯类和头孢菌素对革兰阴性菌都有较高的敏感性,多重耐药率14.4%,12.8%的细菌对5类以上抗菌药耐药。结论艾滋病合并细菌性血流感染者,革兰阳性菌多重耐药率更高,治疗时可以选择利奈唑胺、替加环素、万古霉素及喹奴普汀/达福普汀。喹诺酮类、碳青霉烯类和头孢菌素对革兰阴性菌较敏感。Objective To explore the prevalence of bacterial bloodstream infection in AIDS patients,and to learn the pathogen species drug resistance among AIDS patients.Methods We retrospectively collected the data of AIDS patients with bacteria isolated from blood culture in Shanghai Public Health Clinical Center from 2015 to 2020.The species of pathogenic bacteria and the antibiotic resistance were analyzed,and the proportion of multiple resistance was also calculated.Results The positive rate of bacteria in bloodstream between 2015 and 2020 was 4.48%in AIDS patients.128 strains(59.3%)of gram-positive bacteria were detected,83 strains were reported to be resistant to penicillin,and the resistance rate to erythromycin was 94%and 91.4%No Linezolide,Tigecycline,Vancomycin,Quinolputin/Dapoptine resistance were detected.The multiple drug resistance rate was 38.6%,and 39.7%of the bacteria were resistant to more than 5 classes of antibiotics.Gram-negative bacteria were detected in 88 patients(40.7%),and drug resistance was reported in 70 patients,the resistance rate to Ampicillin was 81.6%.Quinolones,Carbopenems and Cephalosperins all had high sensitivity to gram-negative bacteria.The multiple drug resistance rate was 14.4%, and 12.8% of the bacteria were resistant to more than 5 classes of antibiotics.Conclusions For AIDS patients with bacterial blood flow infection,the multiple drug resistance rate of grampositive bacteria is higher, linezolid, tigecycline, vancomycin and quinuptine/daphoputin can be selected fortreatment . Quinolones,Carbopenems,and Cephalosperins all have high sensitivity to gram-negative bacteria.

关 键 词：人类免疫缺陷病毒 艾滋病 血流感染 细菌 药敏 

分 类 号：R512[医药卫生—内科学]