艾滋病合并细菌性肺炎病原分布及耐药情况分析

目的探讨艾滋病合并细菌性肺炎的病原分布特点及耐药性，为临床治疗艾滋病合并细菌性肺炎提供依据。方法应用回顾性分析方法，选择2010年1月至2013年8月在我院住院的细菌性肺炎患者238例，按是否感染艾滋病病毒（HIV）将患者分为A、B两组，每组119例，A组为艾滋病合并细菌性肺炎患者，B组为非艾滋病细菌性肺炎患者，按照《全国临床检验操作规程》采用常规方法对细菌性肺炎病原菌进行分离鉴定；采用CLSI推荐的K．B法进行药物敏感试验和评价。结果分离出238株病原菌，其中痰标本分离出173株，占72．7％；其余分别分离自纤维支气管镜（FOB）检查的灌洗液、胸腔积液、肺穿刺组织学标本。A组119株病原菌中：革兰阴性（G-）菌88株，耐药株38株；革兰阳性（G＋）菌31株，耐药株19株。B组119株病原菌中：革兰阴性（G-）杆菌43株，耐药株16株；革兰阳性（G＋）菌76株，耐药株20株。结论艾滋病合并细菌性肺炎感染病原菌主要以G-杆菌为主，且耐药现象明显。药敏试验结果可以为临床用药提供-定参考。

Distribution and antimicrobial resistance of pathogens isolated from AIDS patients with bacterial pneumonia

Objective To explore the distribution and antimicrobial resistance of pathogens in AIDS patients with bacterial pneumonia, providing basis for clinical treatment. Method 238 bacterial pneumonia inpatients from January 2008 to August 2013 were retrospectively analyzed. All the cases were divided into two groups with 119 cases in each. AIDS patients with bacterial pneumonia were in group A, while bacterial pneumonia patients without AIDS in group B. Pathogens of bacterial pneumonia were isolated and identified based on National Chnical Laboratory Operating Procedures. Drug sensitivity were tested and evaluated with K. B that recommended by CLSI. Results 238 strains of pathogenic bacteria were isolated, of which 173 strains were isolated from sputum （ accounting for 72.7% ） and the rest from lavage fluid of fiberoptic bronchoscopy （ FOB）, pleural effusion, and pulmonary biopsy. There were 88 gram-negative （G-） strains （with 38 drug-resistant strains） and 31 gram-positive （G-） strains （with 19 drug-resistant strains） in group A,while group B contain 43 gram-negative （G-） strains （with 16 drug-resistant strains） and 76 gram-positive （ G- ） strains （with 20 drug-resistant strains）. Conclusion The pathogens in AIDS patients with bacterial pneumonia are mainly gram-negative bacterial, and the drug resistance is obvious. Drug sensitivity test may provide basis for clinical application of antimicrobial agents.