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预防医学  2018, Vol. 30 Issue (9): 874-878    DOI: 10.19485/j.cnki.issn2096-5087.2018.09.003
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艾滋病合并血流感染病原体种类及耐药分析
杨宗兴1,叶荣夏2,闫俊1,师金川1,朱明利1,喻剑华1
1.杭州市西溪医院,浙江 杭州 310023;
2.浙江省中医院下沙院区
Analysis of types and antimicrobial susceptibility of pathogens in AIDS patients with bloodstream infection
YANG Zong-xing*,YE Rong-xia,YAN Jun,SHI Jin-chuan,ZHU Ming-li,YU Jian-hua
*Xixi Hospital of Hangzhou,Hangzhou,Zhejiang 310023,China
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摘要 目的 了解艾滋病合并血流感染患者的病原体种类及耐药性。方法 收集2012—2015年在杭州市西溪医院住院治疗的94例艾滋病合并血流感染患者的临床资料,对其血培养分离的病原体种类和耐药情况进行描述性分析。结果 94例患者共分离出菌株109株,其中分枝杆菌4株,占3.67%;革兰阳性菌45株,占41.29%,以表皮葡萄球菌最多(10.09%);革兰阴性菌34株,占31.19%,以大肠埃希菌最多(7.34%);真菌26株,占23.85%,包括马尔尼菲蓝状菌(13.76%)和新型隐球菌(10.09%)。革兰阳性菌对喹奴普汀/达福普汀、利奈唑胺、万古霉素、替加环素和呋喃妥因的耐药率均为0.00%,对莫西沙星耐药率为2.44%;革兰阴性菌对哌拉西林/他唑巴坦、厄他培南和亚胺培南3种药物的耐药率均为8.70%。结论 艾滋病合并血流感染患者病原体包括一定的机会感染病原体,对常用的三线抗菌药物敏感性较高。
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杨宗兴,叶荣夏,闫俊,师金川,朱明利,喻剑华
关键词 艾滋病血流感染败血症病原体    
AbstractObjective To investigate the types and antimicrobial susceptibility of pathogens in AIDS patients with bloodstream infection. Methods Demographic and clinical data of ninety four AIDS patients with bloodstream infection hospitalized in our hospital between 2012 and 2015 were collected. Descriptive analysis was conducted to investigate the types and antimicrobial susceptibility of pathogens of bloodstream infection. Results A total of 109 strains were isolated,including 4 strains of mycobacteria(3.67%),45 strains of gram positive bacteria(41.29%)with Staphylococcus epidermidis ranking first (10.09%),34 gram negative bacteria (31.19%)with Escherichia coli ranking first(7.34%),26 strains of fungi (23.85%),including Talaromyces marneffei(13.76%)and Cryptococcus neoformans(10.09%). In gram positive bacteria,zero resistance was observed in quinupristin/Dafoe leptin,linezolid,tigecycline,vancomycin,and nitrofurantoin,and the resistance rate was 2.44% with moxifloxacin. In gram negative bacteria,the same drug resistance rate of 8.70% was observed in piperacillin/tazobactam,imipenem and ertapene,respectively. Conclusion In AIDS patients with bloodstream infections,strains include certain opportunistic pathogens,mainly fungi . The pathogens are highly sensitive to the three commonly used line antimicrobial agents .
Key wordsAIDS    Bloodstream infection    Sepsis    Pathogen
     出版日期: 2018-09-04
ZTFLH:  R512.91  
基金资助:浙江省医药卫生科技计划项目(2015KYB321);杭州市科技厅科技发展计划项目(20150733Q50);杭州市社会发展项目(20160533B54)
通信作者: 喻剑华,E-mail:yujhmc@126.com   
作者简介: 杨宗兴,博士,医师,主要从事艾滋病临床及科研工作
引用本文:   
杨宗兴,叶荣夏,闫俊,师金川,朱明利,喻剑华. 艾滋病合并血流感染病原体种类及耐药分析[J]. 预防医学, 2018, 30(9): 874-878.
YANG Zong-xing,YE Rong-xia,YAN Jun,SHI Jin-chuan,ZHU Ming-li,YU Jian-hua. Analysis of types and antimicrobial susceptibility of pathogens in AIDS patients with bloodstream infection. Preventive Medicine, 2018, 30(9): 874-878.
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http://www.zjyfyxzz.com/CN/10.19485/j.cnki.issn2096-5087.2018.09.003      或      http://www.zjyfyxzz.com/CN/Y2018/V30/I9/874
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