摘要
目的探讨艾滋病合并败血症患者的病原菌构成及耐药性,为指导临床合理用药和抗感染治疗提供依据。方法回顾性分析2007年1月-2011年12月50例艾滋病合并败血症患者的病原菌分布及药敏率。结果 50例艾滋病合并败血症患者检出革兰阴性杆菌20株占40.0%,以沙门菌属最多占16.0%,耐药率>50.0%的有阿莫西林、头孢噻吩、磺胺甲噁唑/甲氧苄啶、妥布霉素、庆大霉素,分别为80.0%、60.0%、55.5%、50.0%、50.0%,疗效最好为美罗培南、亚胺培南;检出革兰阳性球菌8株占16.0%,以葡萄球菌属为主占12.0%,对青霉素、四环素、红霉素耐药率最高,分别为75.0%、62.5%、50.0%,对克林霉素、米诺环素、替考拉宁、夫西地酸、万古霉素、喹奴普汀/达福普汀、呋喃妥因及苯唑西林均100.0%敏感;检出真菌22株占44.0%,马尔尼菲青霉菌最多占36.0%,对氟康唑、两性霉素B和5-氟胞嘧啶均敏感。结论艾滋病合并败血症患者最常见的病原菌为真菌,病原菌对多种抗菌药物耐药率高,临床医师应积极完善血培养,合理选用抗菌药物,防止抗菌药物滥用及新耐药菌株的产生。
OBJECTIVE To investigate the distribution and drug resistance of pathogenic bacteria in the AIDS patients with septicemia.METHODS The distribution and drug susceptibility of the pathogens in 50 AIDS patients with septicemia were retrospectively analyzed from Jan 2007 to Dec 2011.RESULTS There were totally 20（40.0%） strains of gram-negative bacteria among which Salmonella was the main species（16.0%）,the drug resistance rates to amoxicillin,cefalotin,trime thopnim sulfame thoxazole,tobramycin,gentamicin were 80.0%,10.0%,55.5%,50.0%,and 50.0%.There were 8 strains of gram-positive cocci（16.0%）,Staphylococcus was the most common species.accounting for 12.0%,the drug resistance rates to penicillin,tetracycline and erythromycin were 75.0%,62.5%,and 50.0%,respectively,the drug susceptibility rates to clindamycin,minocycline,teicoplanin,fusidinsaure,vancomycin,quinupristin/dalfopristin,nitrofurantoin and oxacillin were 100.0%.There were 22（44.0%） strains of fungi,Penicillium marneffei was the most common species（36.0%）,which was sensitive to fluconazole,amphotericin B,and 5-flucytosin.CONCLUSION The fungi are the predominant pathogens in the AIDS patients with septicemia.The bacteria are diversified,the drug resistance rates are high to a variety of antibiotics,the clinicians should actively perform the blood culture so as to prevent the abuse of antibiotics and the emergence of drug resistant strains.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2013年第8期1969-1971,共3页
Chinese Journal of Nosocomiology
基金
广西壮族自治区卫生厅科研课题(Z2011057)
广西壮族自治区南宁市科学研究及技术开发项目基金(南科发:201106039c)
关键词
艾滋病
败血症
病原菌
耐药性
AIDS
Septicemia
Pathogenic bacteria
Drug resistance
