734株HIV/AIDS患者感染菌群分布及耐药性分析
投稿时间:2015-04-24  修订日期:2015-05-06  点此下载全文
引用本文:徐新民,华文浩,李敏,郭晶晶,陆瑶,李瑞红,王慧珠.734株HIV/AIDS患者感染菌群分布及耐药性分析[J].医学研究杂志,2015,44(10):100-103
DOI: 10.11969/j.issn.1673-548X.2015.10.028
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作者单位E-mail
徐新民 100015 首都医科大学附属北京地坛医院检验科  
华文浩 100015 首都医科大学附属北京地坛医院检验科  
李敏 100015 首都医科大学附属北京地坛医院检验科  
郭晶晶 100015 首都医科大学附属北京地坛医院检验科  
陆瑶 100015 首都医科大学附属北京地坛医院检验科  
李瑞红 100015 首都医科大学附属北京地坛医院检验科  
王慧珠 100015 首都医科大学附属北京地坛医院检验科 whz660527@sina.com 
中文摘要:目的 了解笔者医院HIV/AIDS患者感染病原菌的分布及耐药情况,以指导临床医师合理用药。 方法 对笔者医院2009年1月~2014年12月收治的HIV/AIDS患者各类标本采用自动微生物分析仪及配套试剂进行细菌鉴定与药敏试验,结果按CLSI 2014年版标准判读,采用WHONET 5.6软件进行数据分析。 结果 在分离的734株病原菌中,结核分枝杆菌为主要机会性感染菌,占9.27%,其余病原菌以铜绿假单胞菌、大肠杆菌、肺炎克雷伯菌、阴沟肠杆菌、金黄色葡萄球菌、表皮葡萄球菌、溶血葡萄球菌、白假丝酵母菌、马内菲青霉菌分列其后。亚胺培南对各种肠杆菌科细菌有较强抗菌活性。大肠杆菌对第2、3代头孢菌素敏感度较低,对氨苄西林、哌拉西林、左氧氟沙星和环丙沙星耐药率也较高,达70.0%~95.1%;凝固酶阴性葡萄球菌和金黄色葡萄球菌对青霉素全部耐药,对红霉素和克林霉素耐药率也较高,前者对这两种抗菌药耐药率均高达90%以上。 结论 结核分枝杆菌为HIV/AIDS患者的主要机会性感染菌,细菌耐药现象比较严峻,临床医生应根据药敏结果合理选择抗菌药物。
中文关键词:HIV/AIDS患者  病原菌分布  耐药性  抗菌药物
 
Pathogens Distribution and Resistance Analysis of 734 Strains in HIV/AIDS Patients
Abstract:Objective To understand the pathogens distribution and drug resistance of HIV/AIDS patients in our hospital and to guide clinicians to use drug rationally. Methods We used automated microbiological analyzer and corresponding reagents to perform bacterial identification and drug susceptibility test for HIV/AIDS patients in January 2009 to December 2014 in our hospital. The results were determined by CLSI 2014 and WHONET 5.6 software was used for data analysis. Results Among 734 strains, the Mycobacterium tuberculosis is the main opportunity bacterial infection, accounting for 9.27%, and followed by Pseudomonas aeruginosa, Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae, Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus haemolyticus, Candida albicans and Maerneifei penicillium. Imipenem has strong antibacterial activity for Enterobacteriaceae. Escherichia coli has a lower sensitive rate for the second and the third generation cephalosporins and resistant rate was 70.0%-95.1% for ampicillin, piperacillin, levofloxacin and ciprofloxacin. Coagulase-negative staphylococci and Staphylococcus aureus were resistant to penicillin, and the resistant rate for erythromycin and clindamycin was also higher. The former of these two antibiotic resistance rates was as high as 90%. Conclusion Mycobacterium tuberculosis was the major opportunity bacterial. Resistance phenomenon of bacterial is severe and the clinician should choose antibiotics reasonably based on susceptibility results.
keywords:HIV/AIDS patients  Pathogens distribution  Drug resistance  Antibiotics
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