Clinical features and pathogens of 66 elderly cases of acquired immune deficiency syndrome compliated with septicemia

doi:10.3877/cma.j.issn.1674-1358.2018.03.019

Abstract

Abstract:

Objective

To investigate the clinical features and distribution of pathogen in the elderly patients of acquired immune deficiency syndrome (AIDS) complicated with septicemia.

Methods

The clinical data, distribution of pathogen and drug resistance of 66 elderly patients with AIDS in Hengxian People’s Hospital from January 2011 to December 2016 were analyzed, retrospectively.

Results

The symptoms of cough, sputum, fever, poor appetite, anaemic, angular, anemia, hyponatremia, hypoalbuminemia, liver function damage were common in 66 patients, many cases were complicated with oral fungal infections, lung infection and senile chronic diseases, with high fatality rate. There were 55 cases with fungal infection, among which Penicillium marneffei was the most common, and was sensitive to all anti-fungal drugs. Ten cases were infected with Gram-negative bacteria, among which Salmonella was the most common. The resistance rate of pathogenic bacteria to amoxicillin, tobramycin, sulfamethoxazole/methoxybenzidine, cephalothiophene and gentamycin were all high. Two cases with Gram-positive bacterial infection were 100% sensitive to clindamycin, minocycline, tycorrine, fusidic acid, vancomycin, quinoluptin/dafuptin, furantoin and benzooxicillin.

Conclusions

The clinical symptoms of senile AIDS patients with sepsis in Hengxian county, Guangxi were complex and diverse, with many complications and high fatality rates. The main pathogenic bacteria are fungi, with high sensitivity to antifungal drugs.

Key words: Acquired immune deficiency syndrome, Septicemia, Pathogen, Clinical features

Feng Yu, Feili Liang, Meirong Li, Min Fang, Jizhou Wu. Clinical features and pathogens of 66 elderly cases of acquired immune deficiency syndrome compliated with septicemia[J]. Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition), 2018, 12(03): 296-300.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhsyhlcgrbzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-1358.2018.03.019

https://zhsyhlcgrbzz.cma-cmc.com.cn/EN/Y2018/V12/I03/296

Figures/Tables 6

References 23

[1]	Gleason LJ, Luque A E, Shah K. Polypharmacy in the HIV-infected older adult population[J]. Clin Interv Aging,2013:8(21):749-763.
[2]	陈世艺, 徐永芳, 黄娜, 等. 老年人艾滋病患者HIV感染相关知识及其危险因素分析[J]. 中国皮肤性病学杂志,2015,29(10):1049-1051.
[3]	Blaylock JM, Wortmann GW. Care of the aging HIV patient[J]. Clev Clin J Med,2015,82(7):445-455.
[4]	曾小良, 李永振, 覃祺, 等. 60例老年HIV/AIDS临床特点及治疗效果[J]. 浙江预防医学,2015,27(9):922-923.
[5]	余丰, 梁飞立, 吴继周, 等. 老年HIV感染者/AIDS患者临床特点及治疗效果分析[J]. 中国皮肤性病学杂志,2017,31(2):180-182.
[6]	Dellinger PR. Surving sepsis campaign guidelines for management of severe sepsis and septic hock[J]. Critcare Med,2004,32(3):858-873.
[7]	余丰, 梁飞立, 卫奕荣, 等. 50例艾滋病败血症病原菌分布及耐药分析[J]. 中华医院感染学杂志,2013,23(8):1970-1971.
[8]	Ogunsola FT, Arewa DG, Akinsete IE, et al. Aetiology of bacteraemia among adult AIDS patients attending Lagos University Teachig Hospital (LUTH), Lagos, Nigeria[J]. Niger Postgrad Med J,2009,16(3):186-192.
[9]	许世申, 陈国伟. 艾滋病合并败血症52例临床特点和病原菌分析[J]. 北方药学,2015,12(5):165-166.
[10]	Shalaka NS, Garred NA, Zeglam HT, et al. Clinical profile and factors associated with mortality in hospitalized patients with HIV/AIDS: a retrospective analysis from Tripoli Medical Centre, Libya, 2013[J]. East Mediterr Health J,2015,21(9):635-646.
[11]	Japiassu AM, Amancio RT, Mesquita EC, et al. Sepsis is a major determinant of outcome in critically ill HIV/AIDS patients[J]. Critical Care,2010,14(4):152-156.
[12]	余丰, 梁飞立, 邓梅花, 等. 艾滋病合并败血症44例临床特点和病原菌分析[J]. 中国热带医学,2012,12(8):968-970.
[13]	Wang YF, Xu HF, Han ZG, et al. Serological surveillance for Penicillium marneffeiinfection in HIV-infected patients during 2004-2011 in Guangzhou, China[J]. Clin Microbiol Infect,2015,21(26):484-489.
[14]	Liu H, He X, Levy JA, et al. Psychological impacts among older and younger people living with HIV/AIDS in Nanning, China[J]. J Aging Res,2014,2014:576592.
[15]	中国疾病预防控制中心性病艾滋病预防控制中心. 国家免费艾滋病抗病毒药物治疗手册[M]. 北京: 人民卫生出版社,2016:16.
[16]	余丰, 梁飞立, 吴继周. HIV感染者/AIDS患者抗病毒治疗早期预后的影响因素研究进展[J]. 医学综述,2016,22(5):863-865.
[17]	余丰, 吴继周, 李玫蓉, 等. 老年HIV/AIDS抗病毒治疗预后的影响因素[J]. 中国热带医学,2017,17(1):88-90.
[18]	Zhao GQ, Ran YP, Xiang Y. Penicillium marneffei infection in the mainland of China:a systematic review on its clinical and epidemiological feature[J]. Chin J Mycol,2007,2(2):68-72.
[19]	欧紫娟, 陈胜华, 蔡恒玲, 等. AIDS患者血液与脑脊液中真菌检测及药敏分析[J]. 中南医学科学杂志,2016,44(1):35-36.
[20]	杨凌婧, 范红. 艾滋病马尔尼菲青霉菌感染研究进展[J]. 实用医院临床杂志,2015,12(5):246-247.
[21]	Zheng JD, Gui X, Cao Q, et al. A clinical study of acquired immunodeficiency syndrome associated Penicillium marneffei infection from a non-endemic area in China[J]. PLoS One,2015,10(6):e0130376.
[22]	Stephenie YN, Wong KF. Penicillium marneffei infection in AIDS[J]. Pathol Res Inter,2011,10:e764293.
[23]	叶荣夏, 喻剑华, 刘寿荣. 艾滋病合并沙门菌败血症6例分析[J]. 浙江预防医学,2016,28(5):487-488.

症状	例（%）
发热	41（62.12）
咳嗽咯痰	42（63.63）
纳差乏力	58（87.87）
腹痛	12（18.18）
腹泻	8（12.12）
体重减轻> 10%	46（69.69）
气促	10（15.15）
淋巴结肿大	25（37.87）
肝脾肿大	25（37.87）
肺部啰音	26（39.39）
胸腹水	28（42.42）
口腔黏膜白斑	40（60.60）

症状	例（%）
发热	41（62.12）
咳嗽咯痰	42（63.63）
纳差乏力	58（87.87）
腹痛	12（18.18）
腹泻	8（12.12）
体重减轻> 10%	46（69.69）
气促	10（15.15）
淋巴结肿大	25（37.87）
肝脾肿大	25（37.87）
肺部啰音	26（39.39）
胸腹水	28（42.42）
口腔黏膜白斑	40（60.60）

实验室检查	例（%）
白细胞减少	25（37.87）
白细胞升高	5（7.57）
贫血	64（96.96）
血小板减少	30（45.45）
肝功能损伤	53（80.30）
肾功能损害	25（37.87）
低氧血症	28（42.42）
低钠血症	47（71.21）
低钾血症	18（27.27）
低蛋白血症	65（98.48）
凝血功能异常	21（31.81）
肺部CT渗出性病灶	55（83.33）

实验室检查	例（%）
白细胞减少	25（37.87）
白细胞升高	5（7.57）
贫血	64（96.96）
血小板减少	30（45.45）
肝功能损伤	53（80.30）
肾功能损害	25（37.87）
低氧血症	28（42.42）
低钠血症	47（71.21）
低钾血症	18（27.27）
低蛋白血症	65（98.48）
凝血功能异常	21（31.81）
肺部CT渗出性病灶	55（83.33）

并发症	例（%）
肺结核	12（18.18）
淋巴结结核	15（22.72）
口腔真菌感染	23（34.84）
肺部（细菌、真菌）感染	44（66.66）
乙型病毒性肝炎	9（13.63）
丙型病毒性肝炎	1（1.51）
耶氏肺孢子虫肺炎	12（18.18）
老年慢性病	20（30.30）

Please choose a citation manager

Content to export