摘要
目的分析泉州市第一医院艾滋病合并血流感染病原体分布及耐药性,为临床诊治提供参考。方法收集2015年1月至2019年1月在福建省泉州市第一医院住院的96例艾滋病合并血流感染患者的临床资料,对其血培养分离的病原体分布和耐药情况进行描述性分析。结果在110株分离的病原菌中真菌占63.6%(70株),革兰阴性杆菌占16.4%(18株),革兰阳性球菌占11.8%(13株),分枝杆菌占8.2%(9株)。病原菌中,马尔尼菲篮状菌55株(50.0%),新型隐球菌15株(13.6%),大肠埃希菌5株(4.5%),肺炎克雷伯菌4株(3.6%),沙门杆菌6株(5.5%),凝固酶阴性的葡萄球菌9株(8.2%),非结核分枝杆菌6株(5.5%)。革兰阴性杆菌总体对碳青霉烯类、头孢吡肟、氨曲南、头孢他啶、左氧氟沙星及β内酰胺酶抑制剂复合制剂保持较高敏感性。多数多重耐药的细菌均为肺炎克雷伯菌。复数菌感染有10例。马尔尼菲篮状菌的两性霉素B+伊曲康唑组和伏立康唑+伊曲康唑组两组治疗方案好转率和病死率差异无统计学意义(P>0.05)。新型隐球菌的10株体外药物敏感实验对抗真菌药物全部敏感。新型隐球菌的病死率要高于好转率。结论艾滋病合并血流感染的患者中真菌检出率最高,尤其是马尔尼菲篮状菌和新型隐球菌。新型隐球菌的病死率高,预后差。
Objective To analyze the types and antimicrobial susceptibility of pathogens in the AIDS patients with bloodstream,and to provide reference for clinical diagnosis and treatment.Methods Demographic and clinical data of 96 AIDS patients with bloodstream infection were collected when they were hospitalized in the First Hospital of Quanzhou affiliated to Fujian Medical University between January 2015 and January 2019.Descriptive analysis was conducted to investigate the types and antimicrobial susceptibility of pathogens of bloodstream infection.Results Out of the 110 isolated pathogens,63.6%were fungi(70 strains),16.4%were Gram-negative bacilli(18 strains),11.8%were Gram-positive cocci(13 strains),and 8.2%were mycobacteria(9 strains).Among the pathogens,55 strains of Talaromyces marneffei(50.0%),15 strains of Cryptococcus neoformans(13.6%),5 strains of Escherichia coli(4.5%),4 strains of Klebsiella pneumoniae(3.6%),and 6 strains of Salmonella(5.5%),9 strains of coagulase-negative staphylococci(8.2%),and 6 strains of non-tuberculous mycobacteria(5.5%).Gram-negative bacilli generally remained highly sensitive to carbapenems,cefepime,aztreonam,ceftazidime,levofloxacin,andβlactamase inhibitor compound preparation.Most multi-drug resistant bacteria were Klebsiella pneumoniae.And 10 cases were plural pathogenic infection.There was no statistically significant difference in the improvement rate and mortality between the two treatment regimens of Talaromyces marneffei in amphotericin B+itraconazole group and voriconazole+itraconazole group(P value>0.05).All 10 strains of Cryptococcus neoformans were sensitive to antifungal drugs in vitro.However,the mortality rate of Cryptococcus neoformans was higher than the rate of improvement.Conclusion The detection rate of fungi is the highest of AIDS patients with bloodstream infection,especially Talaromyces marneffei and Cryptococcus neoformans.The treatment effect of the two groups of Talaromyces marneffei is comparable.The mortality rate of Cryptococcus neoformans is high and the
作者
胡丽萍
张志珊
林永年
陈晓婷
张汉辉
朱焱
HU Liping;ZHANG Zhishan;LIN Yongnian;CHEN Xiaoting;ZHANG Hanhui;ZHU Yan(Department of Laboratory Medicine,the First Hospital of Quanzhou affiliated to Fujian Medical University,Quanzhou 362000,Fujian,China)
出处
《中国艾滋病性病》
CAS
CSCD
北大核心
2020年第10期1057-1060,共4页
Chinese Journal of Aids & STD
关键词
艾滋病
血流感染
耐药性
AIDS
bloodstream infection
drug resistance
