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目的了解广东省HIV/AIDS合并真菌感染者的情况及相关的临床和流行病学特征。方法收集HIV/AIDS患者咽拭子、痰、血、中段尿、肛拭子和皮疹刮片标本进行直接真菌镜检和真菌培养。对获得的菌株进行形态学和分子生物学鉴定,同时进行血液CD4+细胞计数。结果71例HIV/AIDS患者中,检出真菌38例,感染率为53.5%;致病菌以白念珠菌为主,占72.8%,其次为马尔尼菲青霉,占20.6%;检出标本主要是咽拭子及痰标本,分别占33.7%和25.0%,其次为尿标本,占17.4%;经性途径感染HIV者真菌感染率为42.5%(17/40),静脉吸毒者感染率为67.7%(21/31);在CD4+低于200个/μL患者真菌感染率为71.05%(27/38);CD4+高于200个/μL感染率为33.33%(11/33)。结论HIV/AIDS合并真菌的感染率高,主要累及与外界相通的腔口部位;感染真菌仍主要为白念珠菌;经血(吸毒)感染HIV者更容易合并真菌感染;真菌感染与CD4+细胞关系密切,CD4+越低真菌感染率越高。
Objective To understand the prevalence of HIV / AIDS-associated fungal infections in Guangdong Province and related clinical and epidemiological features. Methods Throat swabs, sputum, blood, middle urine, rectal swabs and skin rashes from HIV / AIDS patients were collected for direct fungal microscopic examination and fungal culture. The obtained strains were identified morphologically and molecular biology, while blood CD4 + cell count. Results Among the 71 patients with HIV / AIDS, 38 cases were detected with fungi, the infection rate was 53.5%. Candida albicans was the main pathogenic bacteria, accounting for 72.8%, followed by Penicillium marneffei, accounting for 20.6% Mainly throat swabs and sputum samples, accounting for 33.7% and 25.0% respectively, followed by urine samples, accounting for 17.4%; 42.5% (17/40) were infected with HIV through sexual routes, and those infected with intravenous drug users were 67.7% (21/31). The prevalence of fungi was 71.05% (27/38) in patients with CD4 + less than 200 cells / μL. The infection rate of CD4 + higher than 200 cells / μL was 33.33% (11/33). Conclusions The infection rate of HIV / AIDS complicated fungi is high, mainly involving the mouth and mouth which are connected with the outside world. The infected fungi are still predominantly Candida albicans; the infection of HIV is more likely to be associated with fungal infections; the fungal infection is closely related to CD4 + cells , Lower CD4 + fungal infection rate.