艾滋病患者肺部感染病原菌分布与耐药性分析

发布时间：2018-10-12 17:19

【摘要】：目的了解艾滋病(AIDS)患者发生肺部感染的病原菌分布及其耐药性,为临床治疗AIDS发生肺部感染患者使用抗菌药物提供依据。方法收集2010年1月-2014年8月在医院就诊的197例AIDS发生肺部感染患者的痰标本,对其进行痰培养及药物敏感试验,按照《全国临床检验操作规程》,将送检的痰标本采用常规方法进行标本接种及病原菌分离,药敏结果参照CLSI推荐的最新标准判定。结果送检痰标本中培养出病原菌112株,其中革兰阴性菌60株占53.5%、革兰阳性菌5株占4.5%、真菌47株占42.0%;同时混合≥2种病原菌感染的有13例,占11.6%;鲍氏不动杆菌对β-内酰胺类耐药率为38.1%~90.5%,铜绿假单胞菌耐药率为7.1%~85.7%,大肠埃希菌对喹诺酮类耐药率为41.7%~50.0%,肺炎克雷伯菌对氨基糖苷类耐药率为42.9%~57.1%。结论 AIDS患者肺部感染常同时存在多种病原菌,且以革兰阴性菌与真菌为主,呈现混合感染、多药耐药现象,应根据药敏试验结果正确选择抗菌药物。
[Abstract]:Objective to investigate the distribution of pathogenic bacteria and drug resistance of (AIDS) patients with pulmonary infection, and to provide evidence for the clinical treatment of AIDS patients with pulmonary infection. Methods the sputum samples of 197 AIDS patients with pulmonary infection from January 2010 to August 2014 were collected, and the sputum culture and drug sensitivity test were performed. According to the National procedure of Clinical examination, the sputum samples were inoculated and isolated by routine method. The results of drug sensitivity were determined according to the latest standard recommended by CLSI. Results 112 strains of pathogenic bacteria were cultured in sputum samples, of which 60 strains were Gram-negative bacteria (53.5%), 5 strains were Gram-positive bacteria (4.5%), 47 strains were fungi (42.0%), and 13 cases were mixed with more than 2 kinds of pathogens. The resistance rate of Acinetobacter baumannii to 尾 -lactam was 38.1% and that of Pseudomonas aeruginosa was 7.1% and 85.7% respectively. The resistance rate of Escherichia coli to quinolones was 41.70.The resistant rate of Klebsiella pneumoniae to aminoglycoside was 42.9%. Conclusion there are many kinds of pathogenic bacteria in lung infection of AIDS patients, and Gram-negative bacteria and fungi are the main pathogens, which show mixed infection and multidrug resistance. The antimicrobial agents should be correctly selected according to the results of drug sensitivity test.
【作者单位】：佛山市第六人民医院感染科;佛山市第一人民医院检验科;
【基金】：佛山市卫生局科研基金资助项目(2011545)
【分类号】：R446.5;R512.91

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