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目的:分析HIV/AIDS合并口腔念珠菌病(OC)患者的病原学鉴定、临床表型及CD4~+细胞数。方法:选取2015年7月至2016年4月在广西壮族自治区南宁市第四人民医院感染科住院确诊为HIV/AIDS合并OC的患者54例,对其进行临床表型分类,用无菌棉拭子在口腔黏膜病损区取样,接种到科玛嘉念珠菌显色培养基进行病原学鉴定,统计不同临床表型及念珠菌病原学鉴定结果,同时比较CD4~+细胞数<50个/mm~3与CD4~+细胞数>50个/mm~3患者口腔非白色念珠菌的检出率。结果:OC的临床表型以假膜型和红斑型为主,经科玛嘉念珠菌显色培养基分离培养出念珠菌60株,以白色念珠菌检出率最高,为75.00%(45/60),其次为热带念珠菌11.67%(7/60)。54例OC患者CD4~+细胞数范围为5~464个/mm~3,CD4~+细胞数<50个/mm~3的患者口腔样本非白色念珠菌检出率高于CD4~+细胞数>50个/mm~3(χ~2=3.97,P=0.04)。结论:HIV/AIDS患者口腔念珠菌感染临床表型以假膜型和红斑型为主,各种致病菌中以白色念珠菌为主,其次是热带念珠菌;非白色念珠菌为CD4~+细胞数<50个/mm~3患者的常见致病菌。
Objective: To analyze the etiological identification, clinical phenotype and CD4 ~ + cell count of HIV / AIDS patients with oral candidiasis (OC). Methods: From July 2015 to April 2016, 54 patients diagnosed as HIV / AIDS complicated with OC in Inpatient Department of Nanning Fourth People ’s Hospital of Guangxi Zhuang Autonomous Region were selected and their clinical phenotypes were classified. The samples were taken from oral mucosal lesion and inoculated into Candida kamabacum chromogenic medium for etiological identification. The clinical phenotypes and candidiasis were statistically analyzed. The number of CD4 ~ + cells was less than 50 / mm ~ 3 and CD4 ~ + cell count> 50 / mm ~ 3 oral Candida albicans detection rate. Results: The clinical phenotypes of OC were predominantly pseudomembranous and erythema. Candida albicans was isolated and cultured from Candida kamari by culture medium, and Candida albicans was the highest, accounting for 75.00% (45 / 60), followed by Candida tropicalis 11.67% (7/60). The detection rate of non-Candida albicans in oral samples from 54 OC patients with CD4 ~ + cells ranging from 5 to 464 cells / mm ~ 3 and CD4 ~ + cells <50 cells / mm ~ 3 was higher than CD4 ~ + cells > 50 个 /mm~3(χ~2=3.97,P=0.04). Conclusion: The clinical phenotypes of oral candidiasis in HIV / AIDS patients are mainly pseudomembranous and erythema, Candida albicans is the most common pathogenic bacteria, followed by Candida tropicalis; Candida albicans is CD4 ~ + The number of cells <50 / mm ~ 3 common pathogens in patients.