| Objective:To study the region hospitalized HIV/AIDS patients with deep fungal infection, species distribution, drug resistance, and explore risk factors for HIV/AIDS patients with invasive fungal infections, AIDS combined prevention and treatment of deep fungal infections provide a theoretical basis.Methods:A cluster sampling, collection of Kunming Third People’s Hospital of Infectious Diseases200cases of hospital clinical background information on HIV/AIDS patients, clinically suspicious for skin and mucosal fluids and be drawn, direct microscopic examination and fungal culture. By CHROMagar Candida chromogenic medium, rice agar medium species Twain morphology and API20C AUX yeast identification system to do strain identification. Drug susceptibility testing of yeast broth micro-dilution method using yeast antifungal susceptibility testing reference method with specific reference to the revised NCCLS broth dilution method in2002to analyze HIV/AIDS patients with deep fungal infection risk factors.Results:200cases of hospitalized HIV/AIDS patients, there were58cases of fungal culture positive, the infection rate was29.0%. Candida albicans is the most common (54.4%), mainly non-albicans species of Candida glabrata (17.6%), Candida tropicalis (17.6%), Candida krusei (5.9%), followed by Ma Erni other species Philippine Penicillium (2.9%) and Cryptococcus neoformans (1.5%). The experiment found that the phenomenon of coexistence of two fungi,58cases of deep fungal culture-positive AIDS patients were10cases of coexistence of fungi isolated (17.2%), the most common coexisting combination albicans Candida tropicalis+.68fungi detected in vitro antifungal susceptibility test results are shown fluconazole MIC range are0.125-64V-g/ml, itraconazole0.031-16μg/ml, voriconazole and amphotericin0.031-16μg/ml B0.125-1μg/ml. The highest rate of fluconazole resistance (20.6%), followed by itraconazole (14.7%) and voriconazole (13.2%). All strains were sensitive to amphotericin B. Candida albicans strains resistant rates of fluconazole, itraconazole and voriconazole in turn is10.8%,8.1%and5.4%. However, in non-albicans Candida glabrata, Candida tropicalis and Candida krusei to azole antifungal resistance rates higher.2Penicillium and a neoformans on four drugs are sensitive. CD4cells<100cells/μ1(P=0.003) and not receiving HAART therapy (P=0.021) are risk factors for invasive fungal infections. While age (P=0.831), gender (P=0.846), marital status (P=0.725), the route of transmission (P=0.423) were associated with deep fungal infection no correlation. HIV/AIDS combined tumors (4.0%) patients, tuberculosis (11.0%), hepatitis C (27.5%), hepatitis B (2.0%), syphilis (4.5%), genital herpes (10.5%), genital warts (3.5%). Deep fungal infection combined with tumor (P=0.023), tuberculosis (P=0.004) and genital warts (P=0.012) were significantly higher than those without deep fungal infection. CD4+T lymphocytes≤200cells/μ1in patients with invasive fungal infections (P<0.05), tuberculosis (P=0.005), tumor (P=0.016) and genital warts (P<0.05) was significantly higher than CD4+T lymphocytes>200cells/≤l patient, and viral hepatitis, syphilis, genital herpes incidence of CD4+T lymphocyte count was no correlation.Conclusion:The fungal infection is HIV/AIDS patients with common opportunistic infections, the infection rate was29.0%, mainly Candida. All strains resistant to fluconazole highest rate were sensitive to amphotericin B, a low CD4+T lymphocyte count and not receiving HAART treatment of deep fungal infection risk factors. Deep fungal infection is often associated with tuberculosis, cancer and genital warts disease. |
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