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中国防痨杂志 ›› 2021, Vol. 43 ›› Issue (5): 501-505.doi: 10.3969/j.issn.1000-6621.2021.05.016

• 论著 • 上一篇    下一篇

重庆市HIV与NTM双重感染患者的菌种分布及耐药情况

刘敏, 李明俊, 余庆, 何坤, 吴玉珊, 杨红红, 李同心()   

  1. 400036 重庆市公共卫生医疗救治中心感染科
  • 收稿日期:2021-01-19 出版日期:2021-05-10 发布日期:2021-04-30
  • 通信作者: 李同心 E-mail:cqltxin@163.com
  • 基金资助:
    重庆市技术创新与应用发展专项(cstc2019jscx-msxmX0152);重庆市科卫联合医学科研项目(2020FYYX001)

Bacteria distribution and drug resistance of co-infection patients of human immunodeficiency virus and nontuberculous mycobacteria in Chongqing

LIU Min, LI Ming-jun, YU Qing, HE Kun, WU Yu-shan, YANG Hong-hong, LI Tong-xin()   

  1. Department of Infectious Disease,Chongqing Public Health Medical Center, Chongqing 400036,China
  • Received:2021-01-19 Online:2021-05-10 Published:2021-04-30
  • Contact: LI Tong-xin E-mail:cqltxin@163.com

摘要:

目的 了解重庆市HIV与NTM双重感染患者的菌种分布及耐药情况。 方法 回顾性分析2019年6月至2020年6月重庆市公共卫生医疗救治中心收治的44例HIV与NTM双重感染患者的临床资料,统计其临床特征,分析NTM菌种分布情况及药物敏感性试验(简称“药敏试验”)结果。 结果 44例患者中共明确鉴定出8种NTM菌种,鸟分枝杆菌占34.1%(15/44),胞内分枝杆菌占20.4%(9/44),偶发/猪分枝杆菌与堪萨斯分枝杆菌各占11.4%(5/44),龟分枝杆菌脓肿亚群与戈登分枝杆菌各占6.8%(3/44),苏尔加分枝杆菌与缓黄分枝杆菌各占2.3%(1/44),另有2例患者(4.5%)未能明确菌种。对异烟肼、对氨基水杨酸异烟肼、阿奇霉素、利福平的总体耐药率分别为81.8%(36/44)、75.0%(21/28)、61.9%(13/21)、45.5%(20/44),耐药率相对较低者为利福布汀(6.8%,3/44)和克拉霉素(11.4%,5/44)。 结论 重庆市HIV感染者并发NTM感染发生率较高,以鸟分枝杆菌最常见,NTM总体耐药率高,仅对利福布汀、克拉霉素耐药率相对较低。

关键词: HIV感染, 分枝杆菌,非典型性, 微生物敏感性试验, 抗药性,细菌

Abstract:

Objective To investigate the bacterial distribution and drug resistance of human immunodeficiency virus (HIV) and nontuberculous mycobacteria (NTM) co-infected patients in Chongqing. Methods The clinical data of 44 patients with HIV and NTM co-infection admitted to Chongqing Public Health Medical Center from June 2019 to June 2020 were retrospectively analyzed. The clinical characteristics of the patients, the bacteria distribution and the results of drug susceptibility test (DST) of NTM were analyzed. Results A total of eight species of NTM strains were identified in 44 patients. Mycobacterium avium accounted for 34.1% (15/44), Mycobacterium intracellular accounted for 20.4% (9/44), Mycobacterium for tuitum/suis and Mycobacterium Kansas accounted for 11.4% (5/44) respectively, Mycobacterium cheloni abscess subgroup and Mycobacterium gordonii accounted for 6.8% (3/44) respectively, Mycobacterium surga and Mycobacterium chrysogenes accounted for 2.3% (1/44) respectively, and the NTM strains in two patients (4.5%) could not be identified.The overall resistance rates to isoniazid, pasiniazide, azithromycin and rifampicin were 81.8% (36/44), 75.0% (21/28), 61.9% (13/21) and 45.5% (20/44), respectively. The relatively low resistance rates were rifabutin (6.8%, 3/44) and clarithromycin (11.4%, 5/44). Conclusion The incidence of NTM infection in HIV infected people in Chongqing is higher. Mycobacterium avium was the most common. The overall resistance rate of NTM was high, but the resistance rate to rifabutin and clarithromycin was relatively low.

Key words: HIV infection, Mycobacteria, atypical, Microbial susceptibility test, Drug resistance, bacterial