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

doi:10.3969/j.issn.1000-6621.2021.05.016

Abstract

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

LIU Min, LI Ming-jun, YU Qing, HE Kun, WU Yu-shan, YANG Hong-hong, LI Tong-xin. Bacteria distribution and drug resistance of co-infection patients of human immunodeficiency virus and nontuberculous mycobacteria in Chongqing[J]. Chinese Journal of Antituberculosis, 2021, 43(5): 501-505. doi: 10.3969/j.issn.1000-6621.2021.05.016

Figures/Tables 3

药品排序	药品名称	鸟分枝杆菌	胞内分枝杆菌	偶发/猪分枝杆菌	堪萨斯分枝杆菌	龟分枝杆菌脓肿亚群	戈登分枝杆菌	苏尔加分枝杆菌	缓黄分枝杆菌	其他类型分枝杆菌	总耐药
1	异烟肼	100.0 (15/15)	100.0 (9/9)	100.0 (5/5)	40.0 (2/5)	100.0 (3/3)	33.3 (1/3)	0.0 (0/1)	0.0 (0/1)	50.0 (1/2)	81.8 (37/44)
2	利福平	53.3 (8/15)	44.4 (4/9)	80.0 (4/5)	40.0 (2/5)	66.7 (2/3)	0.0 (0/3)	0.0 (0/1)	0.0 (0/1)	0.0 (0/2)	45.5 (20/44)
3	利福布汀	0.0 (0/15)	0.0 (0/9)	40.0 (2/5)	20.0 (1/5)	0.0 (0/3)	0.0 (0/3)	0.0 (0/1)	0.0 (0/1)	0.0 (0/2)	6.8 (3/44)
4	克拉霉素	26.7 (4/15)	0.0 (0/9)	20.0 (1/5)	0.0 (0/5)	0.0 (0/3)	0.0 (0/3)	0.0 (0/1)	0.0 (0/1)	0.0 (0/2)	11.4 (5/44)
5	乙胺丁醇	46.7 (7/15)	44.4 (4/9)	60.0 (3/5)	60.0 (3/5)	66.7 (2/3)	0.0 (0/3)	0.0 (0/1)	0.0 (0/1)	50.0 (1/2)	45.5 (20/44)
6	莫西沙星	40.0 (6/15)	55.6 (5/9)	0.0 (0/5)	60.0 (3/5)	0.0 (0/3)	0.0 (0/3)	0.0 (0/1)	0.0 (0/1)	50.0 (1/2)	34.1 (15/44)
7	利奈唑胺	60.0 (9/15)	33.3 (3/9)	40.0 (2/5)	20.0 (1/5)	0.0 (0/3)	0.0 (0/3)	0.0 (0/1)	0.0 (0/1)	0.0 (0/2)	34.1 (15/44)
8	阿米卡星	40.0 (6/15)	44.4 (4/9)	20.0 (1/5)	40.0 (2/5)	0.0 (0/3)	0.0 (0/3)	0.0 (0/1)	0.0 (0/1)	0.0 (0/2)	29.5 (13/44)
9	亚胺培南- 西司他丁	100.0 (10/10)	100.0 (7/7)	100.0 (2/2)	100.0 (1/1)	-	-	100.0 (1/1)	-	-	100.0 (21/21)
10	阿奇霉素	70.0 (7/10)	57.1 (4/7)	100.0 (2/2)	0.0 (0/1)	-	-	0.0 (0/1)	-	-	61.9 (13/21)
11	头孢西丁	50.0 (5/10)	100.0 (7/7)	50.0 (1/2)	100.0 (1/1)	-	-	0.0 (0/1)	-	-	66.7 (14/21)
12	妥布霉素	30.0 (3/10)	100.0 (7/7)	100.0 (2/2)	0.0 (0/1)	-	-	0.0 (0/1)	-	-	57.1 (12/21)
13	加替沙星	100.0 (10/10)	100.0 (7/7)	0.0 (0/2)	0.0 (0/1)	-	-	0.0 (0/1)	-	-	81.0 (17/21)
14	米诺环素	80.0 (8/10)	100.0 (7/7)	100.0 (2/2)	100.0 (1/1)	-	-	100.0 (1/1)	-	-	90.5 (19/21)
15	磺胺甲唑	100.0 (10/10)	100.0 (7/7)	100.0 (2/2)	100.0 (1/1)	-	-	100.0 (1/1)	-	-	100.0 (21/21)
16	左氧氟沙星	50.0 (4/8)	75.0 (3/4)	66.7 (2/3)	50.0 (2/4)	33.3 (1/3)	0.0 (0/3)	-	0.0 (0/1)	50.0 (1/2)	46.4 (13/28)
17	卷曲霉素	62.5 (5/8)	75.0 (3/4)	0.0 (0/3)	100.0 (4/4)	66.7 (2/3)	33.3 (1/3)	-	0.0 (0/1)	50.0 (1/2)	57.1 (16/28)
18	链霉素	50.0 (4/8)	100.0 (4/4)	100.0 (3/3)	100.0 (4/4)	66.7 (2/3)	33.3 (1/3)	-	0.0 (0/1)	50.0 (1/2)	67.9 (19/28)
19	氯法齐明	37.5 (3/8)	0.0 (0/4)	33.3 (1/3)	75.0 (3/4)	0.0 (0/3)	0.0 (0/3)	-	0.0 (0/1)	0.0 (0/2)	25.0 (7/28)
20	对氨柳酸钠盐	100.0 (8/8)	100.0 (4/4)	100.0 (3/3)	100.0 (4/4)	100.0 (3/3)	33.3 (1/3)	-	0.0 (0/1)	50.0 (1/2)	85.7 (24/28)
21	丙硫异烟胺	100.0 (8/8)	25.0 (1/4)	33.3 (1/3)	50.0 (2/4)	33.3 (1/3)	0.0 (0/3)	-	0.0 (0/1)	50.0 (1/2)	50.0 (14/28)
22	对氨基水杨酸异烟肼	75.0 (6/8)	100.0 (4/4)	100.0 (3/3)	100.0 (4/4)	100.0 (3/3)	33.3 (1/3)	-	0.0 (0/1)	0.0 (0/2)	75.0 (21/28)

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人口学特征	例数	百分率(%)
性别^a
男	34	77.3
女	10	22.7
年龄组(岁)^a
<18	0	0.0
18~59	37	84.1
60~69	7	15.9
有吸烟史	19	43.2
既往有肺结核病史	7	15.9
并发慢性基础疾病
糖尿病	2	4.5
慢性阻塞性肺疾病	2	4.5
临床症状
咳嗽	39	88.6
咳痰	34	77.3
发热	30	68.2
气促	22	50.0
咯血	0	0.0