摘要
目的：了解艾滋病患者血流感染分离菌的临床分布及耐药性，为临床诊断及治疗提供依据。方法采用 BacT／Alert 3D 240全自动血培养仪对成都市公共卫生临床医疗中心2013年1月至2015年12月收集的5010份艾滋病患者的血液标本进行培养，采用 VITEK2 COMPACT 60对分离的病原菌进行鉴定和药物敏感试验。结果5010份患者血标本，共分离出332株病原菌，阳性率为6．6％。其中革兰阳性菌103株（31．0％），革兰阴性菌70株（21．1％），真菌159株（47．9％）。主要病原菌种类依次为新型隐球菌、凝固酶阴性葡萄球菌、马尔尼菲青霉菌、沙门菌属（主要为肠炎沙门菌）、大肠埃希菌和棒状杆菌属，分别占34．3％、13．3％、13．0％、6．6％、5．4％和4．8％。新型隐球菌对临床常用抗真菌药物敏感。83．3％大肠埃希菌对氨苄西林耐药，其中超广谱β-内酰胺酶的检出率为66．7％。结论成都市艾滋病患者血培养病原菌以新型隐球菌为主，该地区患者合并新生隐球菌感染率较高；凝固酶阴性葡萄球菌、马尔尼菲青霉菌和沙门菌属感染也应予以重视。
Objective To investigate the distribution and drug resistance of pathogens causing blood stream infections in acquired immune deficiency syndrome （AIDS）patients,so as to provide evidences for the clinical diagnosis and effective treatment.Methods Totally 5 010 blood samples collected from AIDS patients from January 2013 to December 2015 were cultured with BacT/Alert 3D 240 system at Public Health Clinical Center of Chengdu.Identification and drug susceptibility test of the pathogens were performed with the VITEK2 COMPACT 60.Results A total of 332 pathogenic strains were isolated from 5 010 blood specimens with the positive rate of 6.6%,among which 103 （31.0%）strains were gram-positive,70 （21.1%）strains were gram-negative,and 159 （47.9%）strains were fungi.The main isolated pathogen was Crytococcus neofonmans （34.3%）,followed by Coagulase-negative Staphylococcus （13.3%）,Penicillium marneffei （13.0 %）, Salmonella （6.6%）,Escherichia coli （5.4%）and Corynebacterium （4.8%）.Most isolated Cryptococcus neoformans were susceptible to commonly used antifungal drugs,83.3% of Escherichia coli were resistant to ampicillin,of which 66.7% were extraspectrum β-lactamase positive.Conclusions Pathogens causing blood stream infections in AIDS patients are widely distributed in Chengdu,among which Cryptococcus neoformans is the predominant species,indicating a high prevalence coinfection of Cryptococcus neoformans in AIDS patients in this area.Attention of coagulase negative Staphylococci,Penicillium marneffei and Salmonella spp .infection should also be attached.
出处
《中华传染病杂志》
CAS
CSCD
北大核心
2016年第10期609-612,共4页
Chinese Journal of Infectious Diseases
关键词
血流感染
获得性免疫缺陷综合征
病原菌
分布
抗药性
Blood stream infection
Acquired immune deficiency syndrome
Pathogens
Distribution
Drug resistance
