AIDS合并呼吸道感染病人痰病原菌分布及药物敏感性分析

发布时间：2018-02-22 22:28

本文关键词： 艾滋病病人呼吸道感染病原菌耐药性　出处：《中国艾滋病性病》2017年06期 　论文类型：期刊论文

【摘要】：目的分析艾滋病(AIDS)合并呼吸道感染者痰的病原菌分布及耐药情况,为临床治疗提供数据参考。方法回顾分析2013年1月至2015年3月,重庆市公共卫生医疗救治中心793例AIDS住院病人发生呼吸道感染时,痰中病原菌的分离鉴定及主要病原菌的耐药情况。结果从496例病人的痰中分离出病原菌537株,革兰阴性杆菌(G~-b)263株,占49.0%;其中肺炎克雷伯氏菌84株,大肠埃希菌30株,铜绿假单胞菌23株,洋葱伯克霍尔德菌15株,鲍曼/溶血不动杆菌14株,居分离菌株的前5位。真菌188株,占35.1%;其中白色念珠菌136株。革兰阳性球菌(G~+C)86株,占16.1%;其中溶血葡萄球菌28株,表皮葡萄球菌24株,金黄色葡萄球菌17株,居分离菌株的前3位。产超广谱β-内酰胺酶(ESBLs)菌株检出率7.6%(41/537),耐甲氧西林葡萄球菌检出率为8.9%(48/537)。41例有两种以上菌感染。前5位G~-b对碳青霉烯类、阿米卡星、哌拉西林/他唑巴坦耐药率低于29.0%;前3位G~+C对达托霉素、利奈唑胺、万古霉素无耐药,对青霉素耐药率达88.0%以上;其他抗生素耐药情况因病原菌不同而异。真菌对多种抗真菌药物强敏感。结论 AIDS合并呼吸道感染者痰中病原菌种类多,以Gb为主,真菌比例高,呈现混合感染,耐药情况复杂,在临床治疗中应根据病原菌及耐药情况为病人制定个性化治疗方案。
[Abstract]:Objective to analyze the distribution of pathogenic bacteria and drug resistance in sputum of AIDS patients with AIDS infection, and to provide data for clinical treatment. Methods from January 2013 to March 2015, a retrospective analysis was made. Results 537 strains of pathogenic bacteria were isolated from sputum of 793 inpatients with AIDS in Chongqing Public Health Medical treatment Center, and the drug resistance of the main pathogens was detected in the sputum of 793 patients with respiratory tract infection, and the results showed that 537 strains of pathogenic bacteria were isolated from the sputum of 496 patients. Among them, 84 strains of Klebsiella pneumoniae, 30 strains of Escherichia coli, 23 strains of Pseudomonas aeruginosa, 15 strains of Birkholder Onion, 14 strains of Baumann / Acinetobacter hemolyticus. Among them, 136 strains were Candida albicans, 86 strains were Gram-positive cocci (16.1%), 28 strains were Staphylococcus haemolyticus, 24 strains were Staphylococcus epidermidis, 17 strains were Staphylococcus aureus. The detection rate of ESBLsproducing extended-spectrum 尾 -lactamase (ESBLs) strain was 7.6b / 5370.The detection rate of methicillin-resistant staphylococcus was 8.9%. The positive rate of methicillin-resistant staphylococcus was 8.9% / 5370.41 cases were infected with two or more kinds of bacteria. The drug resistance rate of piperacillin / tazobactam was lower than 29.0.The resistance rate of the first three G~ C to Dastomycin, Linezolidomide and vancomycin was no more than 88.0%, and the resistance rate to penicillin was more than 88.0%. Other antibiotic resistance varies with different pathogens. Fungi are highly sensitive to various antifungal drugs. Conclusion there are many pathogenic bacteria in sputum of AIDS complicated with respiratory tract infection, especially GB, and the proportion of fungi is high, showing mixed infection. The situation of drug resistance is complex, the individualized treatment should be made according to the pathogenic bacteria and drug resistance in clinical treatment.
【作者单位】：重庆市公共卫生医疗救治中心;重庆医药高等专科学校;
【分类号】：R512.91;R56

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