艾滋病患者感染病原菌分布特征及耐药情况

目的 探讨艾滋病患者感染病原菌的分布特征及耐药情况。方法 回顾性收集某院2017—2021年艾滋病住院患者临床资料，分析感染病原体的分布和耐药情况，以及医院感染与社区感染分布的差异。结果 3 677例艾滋病住院患者共检出病原菌1 711株，社区感染、医院感染和定植分别检出1523、77、111株；三者病原体构成比较差异有统计学意义(P<0.001),均以真菌为主，分别占比64.35%、36.36%、50.45%。社区感染以呼吸道感染为主(40.97%),医院感染以血流感染为主(28.57%),两者感染部位构成比比较差异有统计学意义(P<0.001)。艾滋病患者呼吸道感染、血流感染与泌尿道感染中，社区感染与医院感染的病原菌构成比比较差异有统计学意义(P<0.05)。不同菌株多重耐药菌检出率比较差异有统计学意义(P<0.001),耐甲氧西林表皮葡萄球菌检出率最高(58.33%),其次是耐碳青霉烯类鲍曼不动杆菌(44.44%)、耐甲氧西林溶血葡萄球菌(33.33%)与耐甲氧西林金黄色葡萄球菌(33.33%)。结论 艾滋病患者社区感染、医院感染及定植检出病原菌的构成，以...

Distribution characteristics and drug resistance of pathogens in patients with acquired immunodeficiency syndrome

Objective To explore the distribution characteristics and drug resistance of pathogens in patients with acquired immunodeficiency syndrome (AIDS). Methods Clinical data of AIDS patients in a hospital from 2017 to 2021 were collected retrospectively, distribution and drug resistance of infectious pathogens as well as distributional difference between healthcare-associated infection (HAI) and community-associated infection (CAI) were analyzed. Results A total of 1 711 pathogenic strains were isolated from 3 677 AIDS patients, out of which CAI-, HAI- and colonized strain numbers were 1 523, 77, and 111. Pathogenic constituents of 3 groups were significantly different (P<0.001),with Fungi as the major pathogens, accounting for 64.35%, 36.36%, and 50.45% respectively. Respiratory tract infection (RTI) was the major CAI (40.97%), and bloodstream infection (BSI) was the major HAI (28.57%), with a statistically significant difference in the constituent ratio of infection sites between CAI and HAI (P<0.001). In RTI, BSI and urinary tract infection of AIDS patients, difference in constituent ratio of pathogens between CAI and HAI was statistically different (P<0.05).Isolation rate of multidrug-resistant organisms among different strains was statistically different (P<0.001). Isolation rate was the highest in methicillin-resistant Staphy-lococcus epidermidis (58.33%), followed by carbapenem-resistant Acinetobacter baumannii (44.44%), methicillin-resistant Staphylococcus haemolyticus (33.33%) and methicillin-resistant Staphylococcus aureus (33.33%). Conclusion There are obvious differences in the pathogenic constitutions in CAI, HAI and colonization of AIDS patients, as well as in the distribution of infection sites between HAI and CAI. Detection rates of multidrug-resistant organisms of different strains are varied, resistance rate to commonly used antimicrobial agents is high. To prevent the spread of MDROs in community, emphasis should be put on monitoring the dynamics of pathogen drug resis-tance in AIDS patients and rational usage of antimicrobial agents.