HIV/AIDS合并深部真菌感染的调查与耐药研究  

Fungal infection and resistance to anti-fungal agents in patients with HIV/AIDS

作　　者：陈谐捷[1] 蔡卫平[1] 陈劲峰[1] 钟活麟[1] 唐小平[1] 

机构地区：[1]广州市第八人民医院,广东广州510060

出　　处：《中国艾滋病性病》2003年第4期205-207,共3页Chinese Journal of Aids & STD

基　　金：广东省广州市重大科技攻关项目 (编号 :2 0 0 1 -Z - 0 2 3- 0 1 )资助

摘　　要：目的　了解艾滋病病毒 /艾滋病 (HIV/AIDS)合并深部真菌感染的临床状况、病原菌分类及耐药现状。方法　总结近年来收治的 13 1例HIV/AIDS患者的临床资料 ,分析深部真菌感染的发生情况及药敏试验结果。结果　HIV/AIDS患者合并深部真菌感染 48例 ,感染率为 3 6 6% ,其中以念珠菌为主 ,占 61% ,感染部位以消化道为主 ,占 62 7%。随着CD+ 4T淋巴细胞的减少 ,合并深部真菌感染的感染率逐渐增加。念珠菌对益康唑 (ECO)、酮康唑 (KET)、咪康唑 (MIC)、制霉菌素 (NYS)、氟康唑 (FLU )、伊曲康唑 (ITR)、5 氟胞嘧啶 ( 5 FC)、两性霉素B(AMB)耐药率分别为 69 4%、66 7%、58 3 %、44.4%、43 8%、3 6 4%、14 3 %、13 9%。结论　HIV/AIDS患者合并深部真菌感染率高 ,且多有药耐药性 ,特别是对咪唑类抗真菌药物已呈明显耐药 。objective To investigate the incidence, distribution of deep fungal in fection and the susceptibility to anti-fungal agents in people living with HIV /AIDS. Method Clinical data from 131 patients with HIV/AIDS were retrospectively analyz ed for deep fungal infection and the senstivity of isolated fungi to anti-funga l agents. Results The incidence of deep fungal infection w as 36.6(48/131) among al l the patients. Monilia accounted for 61% of the isolated fungi. The digestive t ract was the most frequently affected part (62.7%) of the body. As the number of CD + 4 T lymphocytes decreased, the rate of infection increased. The resist ant ra tes of isolated Candida to Enconazole, Ketoconazole, Miconazole, Nystatin, Fluco nazole, Itraconazole, 5-FC and Amphotericin B were 69.4%, 66.7%, 58.3%, 44.4%, 4 3 8%, 36 4%, 14 3% and 13.9% respectively. Conclusions The incidence of fungal infection in patients with HIV/AIDS is high. Multi-drug resistance is common. Susceptibility test is particularly improtant for clinici ans to choose appropriate anti-fungal agents.

关 键 词：HIV/AIDS 深部真菌感染 调查 耐药研究 

分 类 号：R512.91[医药卫生—内科学]