艾滋病患者细菌性血流感染病原菌分布及耐药情况

  目的  了解艾滋病住院患者细菌血流感染的患病率、病原菌种类及耐药情况。  方法  回顾性收集上海市公共卫生临床中心2015年至2020年血培养分离出细菌的艾滋病患者资料，分析病原菌种类及相应抗菌药物的耐药情况多重耐药的比例。  结果  艾滋病患者中 2015年至2020年间血流感染细菌检出率为4.48%。革兰阳性菌检出128株（59.3%），83株有耐药报告，对青霉素的耐药率为94%，对红霉素的耐药率为91.4%，未检出利奈唑胺、替加环素、万古霉素、喹奴普汀/达福普汀耐药者，多重耐药率38.6%，39.7%的细菌对5类以上抗菌药耐药。革兰阴性菌检出88株（40.7%），70株有耐药报告，对氨苄西林的耐药率为81.6%，喹诺酮类、碳青霉烯类和头孢菌素对革兰阴性菌都有较高的敏感性，多重耐药率14.4%，12.8%的细菌对5类以上抗菌药耐药。  结论   艾滋病合并细菌性血流感染者，革兰阳性菌多重耐药率更高，治疗时可以选择利奈唑胺、替加环素、万古霉素及喹奴普汀/达福普汀。喹诺酮类、碳青霉烯类和头孢菌素对革兰阴性菌较敏感。

Pathogen Distribution and Antimicrobial Susceptibility of Bacterial Bloodstream Infection in AIDS Patients

  Objective  To explore the prevalence of bacterial bloodstream infection in AIDS patients, and to learn the pathogen species drug resistance among AIDS patients .   Methods  We retrospectively collected the data of AIDS patients with bacteria isolated from blood culture in Shanghai Public Health Clinical Center from 2015 to 2020. The species of pathogenic bacteria and the antibiotic resistance were analyzed, and the proportion of multiple resistance was also calculated.   Results  The positive rate of bacteria in bloodstream between 2015 and 2020 was 4.48% in AIDS patients. 128 strains （59.3%） of gram-positive bacteria were detected, 83 strains were reported to be resistant to penicillin, and the resistance rate to erythromycin was 94% and 91.4% No Linezolide, Tigecycline, Vancomycin, Quinolputin/ Dapoptine resistance were detected. The multiple drug resistance rate was 38.6%, and 39.7% of the bacteria were resistant to more than 5 classes of antibiotics. Gram-negative bacteria were detected in 88 patients （40.7%）, and drug resistance was reported in 70 patients , the resistance rate to Ampicillin was 81.6%. Quinolones, Carbopenems and Cephalosperins all had high sensitivity to gram-negative bacteria. The multiple drug resistance rate was 14.4%, and 12.8% of the bacteria were resistant to more than 5 classes of antibiotics.   Conclusions  For AIDS patients with bacterial blood flow infection, the multiple drug resistance rate of gram-positive bacteria is higher, linezolid, tigecycline, vancomycin and quinuptine/daphoputin can be selected for treatment . Quinolones, Carbopenems, and Cephalosperins all have high sensitivity to gram-negative bacteria.