A Research On Clinical Features And Susceptibility Of AIDS Patient With Penicilliosis Marneffei

Objective(s):To investigate the clinical features and demographic characteristics of AIDS patient with penicilliosis marneffei. To study in vitro drug sensitivity and resistance rates of Penicillium marneffei and to provide a theoretical basis for prevention of AIDS patients infected with Penicillium marneffei.Methods:Collection of clinical data and clinical specimens of AIDS patients complicated with penicilliosis marneffei. The susceptible specimens were inoculated on Sabouraud’s medium and were respectively arranged at 37℃ and 25 ℃ thermostat culture. The specimens were identified and isolated. In vitro drug sensitivity test was performed by micro dilution method. The separation of pure strains was performed according to commonly used antifungal drugs i.e. ketoconazole, fluconazole, itraconazole, voriconazole, 5-flucytosine, amphotericin B and caspofungin. Statistical analysis was accomplished by analysis of clinical data, results of drug sensitivity test and drug resistance of AIDS patients with penicilliosis marneffei patients.Results:The study group consisted of 30 cases of AIDS patients complicated with penicilliosis marneffei. Male patients were greater than female patients. Men accounted for 70.00% and female accounted for 30.00%. The age of the patients ranged from 26 to 52 years. Most of the patients were local residents of Yunnan province. The educational background of the patients was mostly elementary or junior school. Socioeconomically most of the patients were farmers or unemployed. The main clinical symptoms included fever, hepatosplenomegaly, lymphadenopathy, oromucosal and cutaneous lesions. In 69.23% of the patients the CD4+T lymphocyte count was less than 50 cells/μl. The results of drug sensitivity tests were lowest for itraconazole, voriconazole and fluconazole. The resistance rate are as follows:no resistant strains were found for amphotericin B and caspofungin, rate of resistance towards voriconazole was 3.33%、rate of resistance towards itraconazole was 6.67%, rate of resistance towards 5-flucytosine was 6.67%, rate of resistance towards fluconazole was 10.00% and rate of resistance towards ketoconazole was 20.00%.Conclusion(s):The clinical manifestations of AIDS patients complicated with penicilliosis marneffei include fever, respiratory symptoms, gastrointestinal symptoms, anemia, hepatosplenomegaly, lymphadenopathy, oromucosal and cutaneous lesions. AIDS patients are likely prone towards opportunistic infections at a CD4+T lymphocyte count< 50cells/μl. Drug sensitivity test revealed that amphotericin B itraconazole and voriconazole were highly sensitive. Whereas the antifungal drug resistance rate respectively descended as ketoconazole (20%), fluconazole (10%), itraconazole (6.67%),5-flucytosine (6.67%), voriconazole (3.33%), caspofungin and amphotericin B. This study analyzed the epidemiological characteristics, clinical features and drug sensitivity test results of AIDS patients complicated with penicilliosis marneffei. The analysis of drug sensitivity test provided the theoretical base for the diagnosis and treatment of local AIDS patients complicated with penicilliosis marneffei disease.