艾滋病并发肺部马红球菌感染的鉴定及药敏分析

目的 探讨艾滋病患者肺部感染马红球菌的生物学性状及耐药情况.方法 取艾滋病患者痰液、血液、经皮肺穿刺物、纤维支气管镜肺泡灌洗液做细菌培养鉴定及药物敏感实验,并对结果进行分析.结果 16株马红球菌为多形态革兰阳性杆菌,均产生橙黄、橘红色素,需氧、无芽孢、无动力、有荚膜;不发酵任何糖类、醇类,触酶、硝酸盐、α-葡萄苷酶呈阳性反应.对环丙沙星和头孢哌酮的敏感率为100.0%,其他药物敏感率依次为氧氟沙星和利福平(87.5%),头孢噻嗪和氯霉素(75.0%);头孢哌酮、氧氟沙星和利福平耐药率为0.0%,环丙沙星、头孢噻嗪耐药率为6.25%,氯霉素为12.5%.结论 马红球菌为人类机会致病菌,掌握其生物学性状及药敏规律,对识别和治疗艾滋病肺部感染患者及指导临床合理用药具有重要的临床价值.

Identification and drug sensitivity analysis of Rhodococcus equi in AIDS patients with lung infection

Objective To explore the biological character and drug resistance situation of Rhodococcus equi in AIDS patients with lung infection.Methods Samples of sputum,blood,percutaneous pulmonary puncture content,fiberoptic bronchoscopy lavage from AIDS patients were collected.Bacteria culture identification was performed.Drug sensitive experiment was processed by K-B method,and the results were analysed.Results 16 strains of Rhodococcus equi were appeared as positive-Gram bacillus.All of them were aerobic bacteria,having orange and nacarat pigments and capsule,without spore and power.They did not ferment any sugar,alcohols,catalase,and nitrate,with α-grape glucosidase positive.The sensitivity rates of the isolates to ciprofloxacin and cefoperazone were both 100%.The sensitivity rates of other drugs were 87.5% for levofloxacin,87.5% for rifabutin,75.0% for cefatrizine,75.0% for chloramphenicol,respectively.The drug resistance rates of ofloxacin and rifabutin were both 0.0%,while those of ciprofloxacin,cefatrizine and chloramphenicol were 6.25%,6.25% and 12.5%,respectively.Conclusion Rhodococcus equi were opportunistic pathogen for human.It was significant to know the biological character and drug resistance rule of Rhodococcus equi for the identification and the treatment of AIDS patients with lung infection in clinical.