【摘要】 目的调查老年获得性免疫缺陷综合征(AIDS)合并败血症患者的临床特点及病原菌构成。方法回顾性分析2011年1月至2016年12月横县人民医院收治的66例老年AIDS合并败血症患者的临床资料,分析病原体分布和耐药。结果入组患者咳嗽、咯痰、发热、纳差、乏力、消瘦、贫血、低钠血症、低蛋白血症、肝功能损害多见,多合并口腔真菌感染、肺部感染及老年慢性病,病死率高。真菌感染55例,以马尔尼菲青霉菌最多,对所有抗真菌药物均敏感。革兰阴性菌感染10例,以沙门氏菌属多见。病原菌对阿莫西林、妥布霉素、磺胺甲噁唑/甲氧苄啶、头孢噻吩和庆大霉素耐药率高。革兰阳性菌感染2例,对克林霉素、米诺环素、替考拉宁、夫西地酸、万古霉素、喹奴普汀/达福普汀、呋喃妥因及苯唑西林均100%敏感。结论广西横县老年AIDS合并败血症患者临床症状复杂多样,并发症多,病死率高。主要致病菌为真菌,对抗真菌药物敏感度高。更多还原

【Abstract】 Objective To investigate the clinical features and distribution of pathogen in the elderly patients of acquired immune deficiency syndrome(AIDS) complicated with septicemia. Methods The clinical data, distribution of pathogen and drug resistance of 66 elderly patients with AIDS in Hengxian People’s Hospital from January 2011 to December 2016 were analyzed, retrospectively. Results The symptoms of cough, sputum, fever, poor appetite, anaemic, angular, anemia, hyponatremia, hypoalbuminemia, liver function damage were common in 66 patients, many cases were complicated with oral fungal infections, lung infection and senile chronic diseases, with high fatality rate. There were 55 cases with fungal infection, among which Penicillium marneffei was the most common, and was sensitive to all anti-fungal drugs. Ten cases were infected with Gram-negative bacteria, among which Salmonella was the most common. The resistance rate of pathogenic bacteria to amoxicillin, tobramycin, sulfamethoxazole/methoxybenzidine, cephalothiophene and gentamycin were all high. Two cases with Grampositive bacterial infection were 100% sensitive to clindamycin, minocycline, tycorrine, fusidic acid, vancomycin, quinoluptin/dafuptin, furantoin and benzooxicillin. Conclusions The clinical symptoms of senile AIDS patients with sepsis in Hengxian county, Guangxi were complex and diverse, with many complications and high fatality rates. The main pathogenic bacteria are fungi, with high sensitivity to antifungal drugs.更多还原