本文關(guān)鍵詞： 艾滋病病人 呼吸道感染 病原菌 耐藥性　出處：《中國艾滋病性病》2017年06期 　論文類型：期刊論文

【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藥情況,為臨床治療提供數(shù)據(jù)參考。方法回顧分析2013年1月至2015年3月,重慶市公共衛(wèi)生醫(yī)療救治中心793例AIDS住院病人發(fā)生呼吸道感染時,痰中病原菌的分離鑒定及主要病原菌的耐藥情況。結(jié)果從496例病人的痰中分離出病原菌537株,革蘭陰性桿菌(G~-b)263株,占49.0%;其中肺炎克雷伯氏菌84株,大腸埃希菌30株,銅綠假單胞菌23株,洋蔥伯克霍爾德菌15株,鮑曼/溶血不動桿菌14株,居分離菌株的前5位。真菌188株,占35.1%;其中白色念珠菌136株。革蘭陽性球菌(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,金黃色葡萄球菌17株,居分離菌株的前3位。產(chǎn)超廣譜β-內(nèi)酰胺酶(ESBLs)菌株檢出率7.6%(41/537),耐甲氧西林葡萄球菌檢出率為8.9%(48/537)。41例有兩種以上菌感染。前5位G~-b對碳青霉烯類、阿米卡星、哌拉西林/他唑巴坦耐藥率低于29.0%;前3位G~+C對達(dá)托霉素、利奈唑胺、萬古霉素?zé)o耐藥,對青霉素耐藥率達(dá)88.0%以上;其他抗生素耐藥情況因病原菌不同而異。真菌對多種抗真菌藥物強(qiáng)敏感。結(jié)論 AIDS合并呼吸道感染者痰中病原菌種類多,以Gb為主,真菌比例高,呈現(xiàn)混合感染,耐藥情況復(fù)雜,在臨床治療中應(yīng)根據(jù)病原菌及耐藥情況為病人制定個性化治療方案。
[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.
【作者單位】： 重慶市公共衛(wèi)生醫(yī)療救治中心;重慶醫(yī)藥高等�？茖W(xué)校;
【分類號】：R512.91;R56

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本文編號：1525466