Species and drugresistance of fungi causing deep infections in AID patients

Abstract:

ObjectiveTo explore the characteristics and drug sensitivity of fungi causing deep fungal infections in AIDS patients, so as to provide evidence for clinical choice of drugs.MethodsFungi were cultured and tested by Bact /ALERT 3D120 blood culture system, and were identified and analyzed by Yeast Biochemical Card (YBC card) according the colony growth characteristics; sensitivity of fungi to antifungal drugs were detected by ATB FUNGUS 3 strip.ResultsTwo hundred and eight fungal strains were isolated from 2 868 different specimens, the constituent ratios of fungipositive specimens were as follows: sputum 34.13% (71 isolates), cerebrospinal fluid 27.40% (57 isolates), blood 12.50% (26 isolates), excrement 10.10% (21 isolates),  bone marrow 7.21% (15 isolates), urine 4.81% (10 isolates), and the other sites 3.85% (8 isolates). Fourteen critically ill patients were isolated 2-3 different strains from multiple sits . Among all isolates, the top five constituent ratios were Cryptococcus neoformans 34.13% (71 isolates), Candida albicans 33.65% (70 isolates), Penicillium marneffei 14.90% (31 isolates),Candida glabrata 5.77% (12 isolates), and Candida tropicalis 3.85% (8 isolates). Cryptococcus neoformans and Candida albicans were highly sensitive to amphotericin B and 5fluorocytosin (sensitive rate was 90.63%-100.00%); 45.45%-57.82% of Candida albicans, Candida glabrata and Candida tropicalis were resistant to fluconazole and voriconazole. Penicillium marneffei was sensitive to amphotericin B and itraconazole, sensitive rate was 95.80% and 84.11% respectively . ConclusionDeep fungal infection is specially distributed among AIDS patients. In order to use antifungal drugs rationally and reduce the emergence of resistant strains, it is important to strengthen the detection and surveillance of pathogens from samples at different sites of AIDS patients.