Analysis Of Etiology In Local HIV-infected Patients Characterized With Primary Symptom Of Lung Infection And Comparison With Simple Pulmonary Infection Patients

Objective:To provide reference for the initial empiric treatment of these patients,we investigated the etiology distribution in local HIV-infected Patients characterized with primary symptom of lung infection.Methods:190 cases of HIV-infected Patients characterized with primary symptom of lung infection and 380 patients of simple pulmonary infections without HIV during 2015 to 2016 in Hangzhou NO.6 Hospital,Ningbo NO.2 Hospital and Cixi People's Hospital were retrospectively analyzed for the etiology distribution.The etiological diagnosis included Pneumocystis carinii infection,and the etiological diagnosis was defined as sputum,bronchoalveolar lavage fluid and Pneumocystis carinii.The etiological diagnosis of bacterial infection is defined as sputum,throat swab,blood culture,and bacteria.The etiological diagnosis of fungal infection is defined as:sputum,throat swab,blood and biopsy specimens,cultures,fungi,or special stains.The etiological diagnosis of tuberculosis infection is defined as sputum smear or sputum and pleural effusion.The etiologic diagnosis of CMV infection is defined as CMV IgM positive or DNAResults:1.There were 154 males and 36 females in the HIV group.The age range(7?82)years and the mean age was(42.7 + 15.3)years.The average male ratio(81.1%)in the HIV group was higher than that in the control group,and there was a statistically significant difference between the two groups,and the age of the HIV group was smaller.2.HIV patients Group shows higher proportion with pneumocystis infection in 121 cases(63.7%),compared with the control group,P<0.01.The proportion of HIV patients group with tuberculosis infection(20 cases,10.5%),is higher compared with the control group,P<0.01.3.62 cases(32.6%)of HIV patients Group had higher proportion of fungal infection,mainly candida albicans,compared with the control group,P<0.01,including the higher proportion of pulmonary fungal infection in 11 cases(5.8%),compared with the control group(P<0.01).4.63 cases(33.2%)of HIV patients Group had bacterial infection in which Klebsiella pneumoniae is more common,compared with the control group.The bacterial infection rate is lower,P<0.01,and there are differences in bacterial spectrum.5.15 cases(7.9%)HIV Patients group had virus infection,all of which were cytomegalovirus infection,and the proportion was higher than that of control,P<0.01.Conclusion:1.In the HIV patients with primary lung infection in this region,the etiology of Pneumocystis carinii infection is as followings.2.The HIV patients with first diagnosis of pulmonary infection in this region are mainly caused by Klebsiella pneumoniae,Enterobacter cloacae,Acinetobacter Bauman and other gram negative bacteria;detection rate is second higher and is higher than that of pathogens including fungi,tuberculosis,herpes virus,after pneumocystis.3.Compared with the simple lung infection group,the proportion of fungi,tuberculosis and virus infection in HIV patients was higher,and the proportion of bacterial infection was lower.There were differences in bacterial infections.4.The results of etiological distribution have important reference value for the selection of initial empiric treatment program for the first visit to this region.