HIV/AIDS合并深部真菌感染的调查与耐药研究

目的：了解艾滋病病毒／艾滋病(HIV／AIDS)合并深部真菌感染的临床状况、病原菌分类及耐药现状。方法：总结近年来收治的131例HIV/AIDS患者的临床资料，分析深部真菌感染的发生情况及药敏试验结果。结果：HIV／AIDS患者合并深部真菌感染48例，感染率为36．6％，其中以念珠菌为主，占61％，感染部位以消化道为主，占62．7％。随着CD4^ T淋巴细胞的减少，合并深部真菌感染的感染率逐渐增加。念珠菌对益康唑(ECO)、酮康唑(KET)、咪康唑(MIC)、制霉菌素(NYS)、氟康唑(FLU)、伊曲康唑(ITR)、5-氟胞嘧啶(5-FC)、两性霉素B(AMB)耐药率分别为69．4％、66．7％、58．3％、44．4％、43．8％、36．4％、14．3％、13．9％。结论：HIV／AIDS患者合并深部真菌感染率高，且多有药耐药性，特别是对咪唑类抗真菌药物已呈明显耐药，应引起临床医生的高度警惕。

Fungal infection and resistance to anti-fungal agents in patients with HIV/AIDS

objective To investigate the incidence, distribution of deep fungal in fection and the susceptibility to anti-fungal agents in people living with HIV /AIDS. Method Clinical data from 131 patients with HIV/AIDS were retrospectively analyz ed for deep fungal infection and the senstivity of isolated fungi to anti-funga l agents. Results The incidence of deep fungal infection w as 36.6(48/131) among al l the patients. Monilia accounted for 61% of the isolated fungi. The digestive t ract was the most frequently affected part (62.7%) of the body. As the number of CD + 4 T lymphocytes decreased, the rate of infection increased. The resist ant ra tes of isolated Candida to Enconazole, Ketoconazole, Miconazole, Nystatin, Fluco nazole, Itraconazole, 5-FC and Amphotericin B were 69.4%, 66.7%, 58.3%, 44.4%, 4 3 8%, 36 4%, 14 3% and 13.9% respectively. Conclusions The incidence of fungal infection in patients with HIV/AIDS is high. Multi-drug resistance is common. Susceptibility test is particularly improtant for clinici ans to choose appropriate anti-fungal agents.