[Pathogens and drug resistance of pulmonary infection in AIDS patients].

Objective: To study the pathogens and drug resistance profiles of pulmonary infection in patients with AIDS.

Methods: The pathogens and their drug susceptibility of pulmonary infection diagnosed by fibrobronchoscopy-induced bronchoalveolar lavage fluid (BALF) culture and/or transbronchial biopsy in 116 AIDS cases were analyzed.

Results: Monopathogenic infection in lungs were detected in 18 cases (15.5%) and mixed infection in 98 cases (84.5%). Of the 116 cases, bacteria were present in 91 patients, fungi in 62, tubercle bacillus in 49, pneumocystis jiroveci in 29, and cytomegalovirus in 11. Ninety-five bacterial strains were isolated from BALF, mainly including Streptococci (34), coagulase negative Staphylococcus (20), Klebsiella pneumoniae (10) and Escherichia (7). The isolated bacteria were resistant to beta-lactam, macrolides, quinolones and aminoglycosides, of which were 14 methicillin-resistant Streptococci (MRS) strains and 12 extended spectrum beta-lactamases (ESBL) strains. Sixty-eight fungal strains were isolated, including 36 Candida mycoderma, 19 Penicillium, 6 Aspergilli and 5 Mold fungi; they were sensitive to amphotericin B but resistant to fluconazole (5.6% - 50.0%) and itraconazole (10.5% - 60.0%).

Conclusion: Pneumonia in AIDS patients are usually caused by multiple pathogens, predominantly consisting of multiresistant bacteria and fungi. Therefore, antibiotics should be rationally chosen according to drug susceptibility test.