CAJ | 학술논문

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.
목적 료해필자의원HIV/AIDS환자감염병원균적분포급내약정황,이지도림상의사합리용약. 방법 대필자의원2009년1월~2014년12월수치적HIV/AIDS환자각류표본채용자동미생물분석의급배투시제진행세균감정여약민시험,결과안CLSI 2014년판표준판독,채용WHONET 5.6연건진행수거분석. 결과 재분리적734주병원균중,결핵분지간균위주요궤회성감염균,점9.27%,기여병원균이동록가단포균、대장간균、폐염극뢰백균、음구장간균、금황색포도구균、표피포도구균、용혈포도구균、백가사효모균、마내비청매균분렬기후. 아알배남대각충장간균과세균유교강항균활성. 대장간균대제2、3대두포균소민감도교저,대안변서림、고랍서림、좌양불사성화배병사성내약솔야교고,체70.0%~95.1%;응고매음성포도구균화금황색포도구균대청매소전부내약,대홍매소화극림매소내약솔야교고,전자대저량충항균약내약솔균고체90%이상. 결론결핵분지간균위HIV/AIDS환자적주요궤회성감염균,세균내약현상비교엄준,림상의생응근거약민결과합리선택항균약물.
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 bac -terial 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 tuber-culosis 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 sensi-tive rate for the second and the third generation cephalosporins and resistant rate was 70.0%-95.1%for ampicillin, piperacillin, levo-floxacin 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 .