|本期目录/Table of Contents|

[1]徐新民,宓连芳,徐 飞,等.AIDS 合并新型隐球菌感染患者的临床特点分析[J].传染病信息,2019,05:418-421.
 XU Xin-min,MI Lian-fang,XU Fei,et al.Analysis on clinical characteristics ofAIDS patients with Cryptococcal neoformans infection[J].Infectious Disease Information,2019,05:418-421.
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AIDS 合并新型隐球菌感染患者的临床特点分析(PDF)

《传染病信息》[ISSN:1007-8134/CN:11-3886/R]

期数:
2019年05期
页码:
418-421
栏目:
论著
出版日期:
2019-11-13

文章信息/Info

Title:
Analysis on clinical characteristics ofAIDS patients with Cryptococcal neoformans infection
文章编号:
1007-8134(2019)05-0418-04
作者:
徐新民宓连芳徐 飞张 燕方 茜李瑞红李 敏王慧珠王雅杰
100015,首都医科大学附属北京地坛医院检验科 (徐新民、徐飞、张燕、方茜、李瑞红、李敏、王慧珠、王雅杰); 252000,聊城市复退军人医院神经内科(宓连芳)
Author(s):
XU Xin-min MI Lian-fang XU Fei ZHANG Yan FANG Qian LI Rui-hong LI Min WANG Hui-zhu WANG Ya-jie*
Department of Clinical Laboratory, Beijing Ditan Hospital, Capital Medical University, 100015, China
关键词:
新型隐球菌临床表现药物敏感性
Keywords:
Cryptococcus neoformans clinical manifestations drug sensitivity
分类号:
R512.91;R519.4
DOI:
10.3969/j.issn.1007-8134.2019.05.009
文献标识码:
A
摘要:
目的了解 AIDS合并新型隐球菌感染患者的临床表现及病原菌对 5种抗真菌药物的敏感性特点。方法收集并分析首都医科大学附属北京地坛医院 2009年 1月—2018年 6月诊断明确的 74例 AIDS合并新型隐球菌感染患者的临床表现,CD4 +、CD8+T细胞计数和脑脊液检测情况等资料;采集患者的血液、脑脊液和肺泡灌洗液等不同类型标本进行培养和鉴定;并对分离菌株进行 5种抗真菌药物的敏感性试验。结果74例 AIDS合并新型隐球菌感染患者均经过病原学确诊,临床表现无特异性,大部分患者以发热、头痛、呕吐为主,68.91%(51/74)的患者脑脊液压力 ≥ 200 mmH2O;临床使用的抗真菌药物主要是两性霉素 B、5 -氟胞嘧啶和氟康唑,大部分患者转归较好;对 60株分离的新型隐球菌进行药物敏感性分析,结果显示,5 -氟胞嘧啶和氟康唑敏感率分别是 91.67%和 83.33%。结论AIDS合并新型隐球菌感染患者的临床表现以头痛、发热为主,脑脊液压力大部分偏高;新型隐球菌对多种抗真菌药敏感,临床主要采用两性霉素B、 5-氟胞嘧啶和氟康唑进行治疗,可根据不同的疾病阶段采取不同的联合用药方案。
Abstract:
ObjectiveTo understand the clinical manifestations of AIDS patients with Cryptococcal neoformans infection and the drug sensitivity of pathogenic bacteria to 5 antifungal drugs. MethodsClinical manifestations of 74 AIDS patients with Cryptococcal neoformans infection who were definitely diagnosed in Beijing Ditan Hospital affiliated to Capital MedicalUniversity from January 2009 to June 2018 were collected and analyzed. CD4+, CD8+ T cell count and cerebrospinal fluid testwere also analyzed. Different specimens such as blood, cerebrospinal fluid and alveolar lavage fluid were collected for cultureand identification and the isolates were tested for the sensitivity to 5 antifungal drugs. ResultsSeventy-four AIDS patients with Cryptococcal neoformans infection were all diagnosed by pathogens, and the clinical manifestations were non-specific. Most patients had fever, headache, and vomiting as the main clinical manifestations and 68.91% (51/74) cases had cerebrospinalfluid pressure ≥ 200 mmH2O. The antifungal drugs used in clinic were mainly amphotericin B, 5-fluorocytosine and fluconazole.Most of the patients had better outcomes. The drug sensitivity analysis of 60 strains of Cryptococcus neoformans showed that the sensitivity rates of 5-fluorocytosine and fluconazole were 91.67% and 83.33%, respectively. ConclusionsHeadache and fever are the major clinical manifestations of AIDS patients with Cryptococcal neoformans infection and cerebrospinal fluid pressure is mostly high. Cryptococcus neoformans is sensitive to many antifungal drugs. The main antifungal drugs used in clinic are amphotericin B, 5-fluorocytosine and fluconazole. Different combination regimens can be adopted according to different disease stages.

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备注/Memo

备注/Memo:
[基金项目]新发突发传染病研究北京市重点实验室开放课题 (DTKF201801)
[作者单位]100015,首都医科大学附属北京地坛医院检验科 (徐新民、徐飞、张燕、方茜、李瑞红、李敏、王慧珠、王雅杰); 252000,聊城市复退军人医院神经内科(宓连芳)
[通信作者]王雅杰,E-mail:wangyajie@ccmu.edu.cn
*Correspondingauthor,E-mail:wangyajie@ccmu.edu.cn
更新日期/Last Update: 2019-11-13