人类免疫缺陷病毒合并结核分枝杆菌感染患者的病原菌分布特征及药敏性  

Distribution characteristics and drug sensitivity of pathogenic bacteria in patients with human immunodeficiency virus combined with Mycobacterium tuberculosis infection

作　　者：周欢 余黄鹏 ZHOU Huan;YU Huangpeng(Department of Pharmacy,Jiujiang Third People's Hospital,Jiangxi Province,Jiujiang 332000,China)

机构地区：[1]江西省九江市第三人民医院药剂科,江西九江332000

出　　处：《中国当代医药》2024年第13期88-91,共4页China Modern Medicine

基　　金：江西省卫生健康委科技计划项目(202140227)。

摘　　要：目的探讨人类免疫缺陷病毒(HIV)合并结核分枝杆菌(MTB)感染患者病原菌分布特征及药敏性。方法选取2021年1月至2023年5月九江市第三人民医院收治的142例HIV及结核分枝杆菌感染患者作为研究对象,按感染情况分为单纯HIV感染组(42例)、单纯MTB感染组(42例)和HIV合并MTB感染组(58例)。记录三组患者病原菌分布情况及对抗结核药物的初始耐药情况。结果HIV合并MTB感染组以真菌最为常见,其次为革兰阴性菌,单纯HIV感染组、单纯MTB组中以革兰阴性菌最为常见。HIV合并MTB感染组真菌分布比例高于单纯HIV感染组、单纯MTB组,差异有统计学意义(P<0.017);三组革兰阳性菌、革兰阴性菌、其他病原体相比,差异无统计学意义(P>0.05);HIV合并MTB感染组对一线抗结核药物耐异烟肼(INH)、耐链霉素(SM)及总初始耐药比例均高于单纯MTB组,差异有统计学意义(P<0.05);两组对二线抗结核药物的耐利福平(RFP)、耐乙胺丁醇(EMB)及对二线抗结核药物耐药情况相比,差异无统计学意义(P>0.05)。结论HIV合并MTB感染患者较两者单纯感染者携带更多真菌,且合并感染者的耐INH、耐SM及总初始耐药比例较高,临床需加以重视。Objective To explore the distribution characteristics and drug sensitivity of pathogenic bacteria in patients with human immunodeficiency virus(HIV)combined with Mycobacterium tuberculosis(MTB)infection.Methods A total of 142 HIV and MTB infected patients admitted to Jiujiang Third People's Hospital from January 2021 to May 2023 were selected as the study objects.They were divided into a simple HIV infection group(42 cases),a simple MTB infection group(42 cases),and a HIV combined with MTB infection group(58 cases)according to their infection status.The distribution of pathogenic bacteria and initial resistance to anti tuberculosis drugs in three groups of patients were recorded.Results Fungi were the most common in the HIV combined with MTB infection group,followed by Gram negative bacteria.Gram negative bacteria were the most common in the HIV infected group and MTB infected group.The proportion of fungal distribution in the HIV combined with MTB infection group was higher than that in the pure HIV infection group and the pure MTB group,and the difference was statistically significant(P<0.017).There were no statistically significant differences among the three groups of Gram positive bacteria,Gram negative bacteria,and other pathogens(P>0.05).The proportion of first-line anti tuberculosis drugs resistant to isoniazid(INH),streptomycin(SM),initial multidrug resistance,and total initial resistance in the HIV combined with MTB infection group were higher than those in the MTB alone group,and the differences were statistically significant(P<0.05).There was no statistically significant difference between the two groups in terms of resistance to second-line anti tuberculosis drugs such as rifampicin(RFP),ethambutol(EMB),and resistance to second-line anti tuberculosis drugs(P>0.05).Conclusion Patients with HIV combined with MTB infection carry more fungi than those with only two infections,and the patients with combined infections is high in INH,SM,and overall initial drug resistance.Clinical attention should be paid

关 键 词：人类免疫缺陷病毒 结核分枝杆菌感染 病原菌分布特征 药敏性 

分 类 号：R512.91[医药卫生—内科学]