AIDS合并呼吸道感染患者痰病原菌分布及药物敏感性分析胡永芳[1.docVIP

AIDS合并呼吸道感染患者痰病原菌分布及药物敏感性分析 ，聂欢1，黄成瑜▲1，谭克辉△2 (1 重庆市公共卫生医疗救治中心，重庆400036； 2重庆医药高等专科学校，重庆400030。) 【摘要】目的 研究艾滋病（acquired immunodeficiency syndrome,AIDS）合并呼吸道感染者痰病原菌分布及耐药情况，为AIDS合并呼吸道感染者的临床治疗提供数据参考。方法 回顾分析重庆市公共卫生医疗救治中心2013年1月至2015年3月期间，AIDS合并呼吸道感染住院患者793例收集痰标本496份分离鉴定痰中病原菌主要病原菌药敏。结果 分离出病原菌537株，革兰氏阴性杆菌263株，肺炎克雷伯氏菌、大肠埃希菌、铜绿假单胞菌、洋葱伯克霍尔德菌、鲍曼/溶血不动杆菌；真菌188株，以白色念珠菌为主；革兰氏阳性球菌86株，以溶血葡萄球菌、表皮葡萄球菌、金黄色葡萄球菌为主。多数对碳青霉烯类强敏感, 对阿米卡星、哌拉西林/他唑巴坦、替卡西林/棒酸次之，对哌拉西林、复方新诺明、头孢曲松、头孢噻肟耐药严重；真菌对多种抗真菌药物强敏感，但也存在天然耐药现象；对达托霉素、利奈唑胺、万古霉素强敏感，对四环素、莫西沙星耐药率较低，对青霉素、阿莫西林/克拉维酸、头孢曲松等10种抗生素耐药严重。结论 AIDS合并呼吸道感染者痰中病原菌种类多，以革兰氏阴性杆菌为主，真菌比例高，呈现混合感染、多药耐药现象。在临床治疗中建议根据病原学检查结果合理使用抗生素。 【关键词】 Analysis of pathogens Isolation and identification and drug sensitivity test in the sputum of AIDS patients with respiratory tract infection Hu Yongfang 1,nie huan1, huangchengyu▲1, Tan Kehui △2 (1 Chongqing public health and medical treatment center，chongqing 400036; 2 Chongqing Medical College, chongqing 400030. ) [Abstract]?Objective?To analyze the pathogen distribution and resistance in the sputum and provide a basis for the clinical treatment of AIDS with respiratory tract infection. Methods: Retrospective analyzed the sputum pathogen distribution and drug resistance of hospitalized AIDS with respiratory tract infection patients in January 2013 to March 2015 in Chongqing municipal public health treatment center．?Results: A total of 537 strains of pathogenic bacteria were isolated, including 263 strains of gram negative bacilli (G-b), pneumonia gram Klebsiella, Escherichia coli, Pseudomonas aeruginosa, onion Burke Burkholderia and Bowman/Acinetobacterhaemolyticus ranked in the top five; 188 strains of fungi were detected, and the detection rate of Candida albicans was the highest ; 86 strains of gram positive cocci (G+C) were detected, the detection rate of ?Staphylococcus haemolyticus, Staphylococcus epidermidis and Staphylococcus aureus was higher. Most of the G-b sensitive to carbapenems, however to piperacillin, cotrimoxazo