老年免疫缺陷病合并败血症患者病原菌分布及药物敏感性分析

目的 探究老年免疫缺陷病合并败血症患者病原菌分布及对药物的敏感性。 方法 回顾性分析2018年1月到2019年10月我院收治的74例老年免疫缺陷病(AIDS)合并败血症患者,血培养细菌检出情况及药物敏感性实验结果。 结果 74例老年AIDS合并败血症患者共检出真菌50株(67.57%),包括马尼尔菲青霉菌31株、新生隐球菌12株、克鲁维酵母菌6株和葡萄牙假丝酵母菌1株；革兰阴性菌16株(21.62%),包括大肠埃希菌5株、铜绿假单胞菌5株、猪霍乱沙门菌4株、人苍白杆菌1株和肺炎克雷伯菌1株；革兰阳性菌8株(10.81%),包括金黄色葡萄球菌3株、屎肠球菌2株、表皮葡萄球菌2株和溶血葡萄球菌1株。真菌对氟康唑、5氟胞嘧啶耐药率均为2.00%,对两性霉素B、伊曲康唑耐药率均为100%；革兰阴性菌对阿莫西林、头孢噻吩等抗菌药物耐药率分别为56.25%、43.75%；革兰阳性菌对四环素、青霉素、红霉素等抗菌药物耐药率分别为87.50%、75.00%、50.00%；参照药敏结果给予抗真菌药物和抗生素治疗,因败血症死亡10例(13.51%),其中4例感染大肠埃希菌,3例铜绿假单胞菌,2例感染金黄色葡萄球菌,1例马尼尔菲青霉菌。 结论 本地区老年免疫缺陷病合并败血症患者感染菌以真菌为主,对大多数抗真菌药物敏感。

Distribution and drug resistance of pathogens in elderly patients with AIDS and sepsis

Objective To observe the distribution and drug sensitivity of pathogen in elderly patients with immunodeficiency disease complicated with septicemia.Methods Seventy-four cases of senile acquired immunodeficiency syndrome(AIDS)complicated with septicemia from January 2018 to October 2019 were retrospectively analyzed.Results In the 74 elderly patients,a total of 50 strains(67.57%)of fungi were detected,including 31 strains of Penicillium marneffei,12 strains of Cryptococcus neoformans,6 strains of Kluyveromyces and 1 strain of Candida lusitaniae;16 strains(21.62%)of Gram-negative bacteria were detected,including 5 strains of Escherichia coli,5 strains of Pseudomonas aeruginosa,4 strains of Salmonella choleraesuis,1 strain of Paleococcus pneumoniae and 1 strain of Klebsiella pneumonia;8 strains(10.81%)of Gram-positive bacteria were detected,including 3 strains of Staphylococcus aureus,2 strains of Enterococcus faecium,2 strains of Staphylococcus epidermidis and 1 strain of Staphylococcus hemolyticus.The drug resistance rates of the fungi to Fluconazole and 5-Fluorocytosine were 2.00%,and the sensitivity rates to Amphotericin B and Itraconazole were 100.00%.The drug resistance rates of Gram-negative bacteria to Amoxicillin and Cefotaxime were 56.25%and 43.75%,respectively;the drug resistance rates of Gram-positive bacteria to Astetracycline,Penicillin and Erythromycin were 87.50%,75.00%,and 50.00%,respectively.The patients were treated with antifungal drugs and antibiotics based on drug sensitivity results;10 patients(13.51%)died of sepsis,among whom 4 were infected with Escherichia coli,3 with Pseudomonas aeruginosa,2 with Staphylococcus aureus,and 1 with Penicillium manilfii.Conclusion Fungi are the main infecting bacteria in elderly immunodeficiency patients with septicemia and are sensitive to most antifungal drugs.