艾滋病住院患者酵母样真菌感染及药物敏感性

Yeast-like fungi infection in hospitalized patients with AIDS and analysis of drug susceptibility

  • 摘要: 目的 了解云南省艾滋病(Acquired immunodeficiency syndrome,AIDS)患者酵母样真菌感染的种类、分布和耐药性,为临床治疗提供依据。方法 采用回顾性调查分析方法,对云南省传染病医院2009-2017年送检标本分离酵母样真菌情况以及常用抗真菌药敏试验结果进行分析。结果 共检测出酵母样真菌1 373株,其中无菌体液中检出菌株348株,其中新型隐球菌327株(94.0%);其他样本中检出菌株1 025株,其中白假丝酵母769株(75.0%)。分离菌在不同年龄分段的分布差异有统计学意义(χ2=263.10,P<0.001),其中31~40年龄段和41~50年龄段患者最多。无菌体液中检出的新型隐球菌对氟康唑的耐药率为4.3%,对两性霉素B的耐药率为0.3%,1 020株常见假丝酵母对唑类药物的耐药率较高,对两性霉素B和氟胞嘧啶的耐药率均较低。结论 AIDS患者酵母样真菌感染以新型隐球菌和白假丝酵母多见,酵母样真菌对氟胞嘧啶和两性霉素B的耐药率低,可作为首选的治疗药物。

     

    Abstract: OBJECTIVE To understand the species of yeast-like fungi causing infection in patients with acquired immunodeficiency syndrome(AIDS) and observe the distribution and drug resistance so as to provide guidance for clinical treatment. METHODS By means of retrospective survey, the species of yeast-like fungi that were isolated from submitted specimens of Yunnan Provincial Infectious Disease Hospital in 2009-20117 and the results of drug susceptibility testing for commonly used antibiotics were observed. RESULTS A total of 1 373 strains of yeast-like fungi were isolated, 348 of which were isolated from sterile body fluid, including 327(94.0%) strains of Cryptococcus neoformans, 1 025 of which were isolated from other specimens, including 769(75.0%) strains of Candida albicans.There was significant difference in the distribution of isolated species among the different age groups of patients(χ2=263.10,P<0.001), and the isolated species of strains were dominant among the patients aged between 31 and 40 years old and the patients aged between 41 and 50 years old.The drug resistance rate of the C. neoformans strains isolated from sterile body fluid to fluconazole was 4.3%, and the drug resistance rate to amphotericin B was 0.3%.The 1 020 strains of common species of Candida were highly resistant to azole drugs, while the drug resistance rates to amphotericin B and flucytosine were low. CONCLUSION C. neoformans and C.albicans are the predominant species of yeast-like fungi causing infection in the AIDS patients, and the drug resistance rates of the yeast-like fungi were low to amphotericin B and flucytosine, which can be chosen as the preferred drugs for treatment.

     

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