2018—2022年我院收治艾滋病患者的细菌分布及耐药性分析

Analysis of Bacterial Distribution and Drug Resistance in AIDS Patients Admitted to Our Hospital from 2018 to 2022

目的:了解艾滋病住院患者细菌种类及耐药情况,为临床合理使用抗菌药物提供依据。方法:从检验科瑞美系统收集云南省传染病医院2018—2022年艾滋病患者分离出细菌的资料,分析细菌种类及相应抗菌药物的耐药情况,以及多重耐药的比例。结果:5年来共分离细菌1863株,其中革兰阳性菌449株(24.10%),耐药139株(30.96%),革兰阴性菌1414株(78.90%),耐药390株(27.58%);细菌及耐药菌株检出样本来源由高到低为呼吸道标本、尿液、分泌物、血液、脓肿穿刺液、脑脊液、胸水、骨髓以及其他。细菌检出所占百分比由高到低为大肠埃希菌、肺炎克雷伯菌肺炎亚种、金黄色葡萄球菌、铜绿假单胞菌、副流感嗜血杆菌。临床分离的细菌标本以呼吸道标本(46.00%)、尿液标本(17.12%)、分泌物(11.92%)为主,多重耐药菌标本以呼吸道标本(43.48%)、尿液标本(22.68%)、分泌物(14.74%)为主。主要细菌在标本分布情况为大肠埃希尿液检出190株,耐药株86株,耐药率20.38%;肺炎克雷伯菌肺炎亚种痰液检出189株,耐药56株,耐药率20.43%;金黄色葡萄球菌痰液检出69株,耐药14株,耐药率9.03%;铜绿假单胞菌痰液检出89株,耐药12株,耐药率8.39%。结论:我院艾滋病患者的细菌感染以革兰阴性菌为主,病原菌的耐药性高,应及时掌握细菌构成及耐药情况,为合理使用抗生素提供依据。标本以痰标本为主,应注意标本质量的控制,保障培养结果的准确性。细菌耐药的防控应多部门协作,保障患者的医疗安全。

Objective:To understand the bacterial species and drug resistance of patients hospitalized with AIDS,and to provide a basis for the rational use of antimicrobial drugs in clinical practice.Methods:Information on bacteria isolated from AIDS patients in Yunnan Infectious Diseases Hospital from 2018 to 2022 was collected from the Rui Mei system of the Department of Laboratory Medicine,and the bacterial species and the corresponding antimicrobial drug resistance,and the proportion of multiple drug resistance were analyzed.Results:Over the past 5 years,a total of 1863 bacterial strains were isolated,of which 449(24.10%)were Gram-positive and 139 were drug-resistant(30.96%),and 1414(78.90%)were Gram-negative and 390 were resistant(27.58%).The sources of samples detected by bacteria and drug-resistant strains from high to low were respiratory specimens,urine,secretions,blood,abscess puncture fluid,cerebrospinal fluid,pleural effusion,bone marrow and others.The percentage of bacteria detected from high to low was Escherichia coli,Klebsiella pneumoniae pneumonia subspecies,Staphylococcus aureus,Pseudomonas aeruginosa,