AIDS患者血液与脑脊液中真菌检测及药敏分析

Analysis of Pathogenic Fungus Isolated from Blood and Cerebrospinal Fluid of AIDS Patients

目的分析艾滋病（AIDS）患者血液及脑脊液中真菌种类及其耐药性,为临床诊疗AIDS患者机会性感染提供参考。方法收集2011～2014年某传染病医院接诊AIDS患者的血液和脑脊液标本,对其中病原性真菌进行分离、鉴定,并对新生隐球菌进行药敏分析。结果共分析AIDS患者血液培养阳性标本477份、脑脊液培养阳性标本109份,真菌检出率分别为66.88%（319/477）和66.97%（73/109）,其中血液中以马内菲青霉菌检出率最高,为53.04%（253/477）,脑脊液中以新生隐球菌检出率最高,占66.06%（72/109）。新生隐球菌对两性霉素B、氟康唑、5-氟胞嘧啶均高度敏感。结论 AIDS患者合并真菌感染率较高,其中常见的是马内菲青霉菌和新生隐球菌。

Objective To investigate the species and drug-resistance of pathogenic fungus isolated from blood and cerebrospinal fluid （CSF） of AIDS patients, so as to provide reference for clinical diagnosis and treatment. Methods The blood and CSF samples were collected from AIDS patients from a hospital for infectious diseases during 2011 to 2014. The pathogenic fungus were isolated and identified, then the drug sensitivity was analyzed. Results Totally 477 blood and 109 CSF specimens were analyzed, and the fungi positive rate were 66.88% （ 319/477 ） and 66.97% （ 73/109 ）. A- mong the 477 blood samples,319 fungi strains were isolated and Penicillium marneffei was the main pathogens which posi- tive rate was 53.04% （253/477）. In the 109 CSF samples,73 fungi strains were isolated and the most common member was Cryptococcus neoformans whose positive rate was 66.06% （72/109）. Cryptococcus neoformans exihibited high sensi- tive to Amphotericin B,Fluconazole and 5-flucytosine. Conclusion AIDS patients have a high opportunity to co-infect with fungus, and the most isolates are P. marueffei and C. neoformans.