Lai Jinglan, Liu Yuming, Ye Hanhui, Chen Yahong
Department of Infectious Diseases, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, People's Republic of China.
Department of Anesthesiology, MengChao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, People's Republic of China.
Infect Drug Resist. 2022 Sep 5;15:5207-5214. doi: 10.2147/IDR.S379100. eCollection 2022.
This study aimed to investigate the epidemiology and etiological spectrums of BSI in Fujian over the past 6 years in the post antiretroviral treatment (ART) era.
A retrospective, observational study was conducted to include positive BSI inpatients with HIV between September 2015 and August 2021 in Mengchao Hepatobiliary Hospital of Fujian Medical University, the largest designated HIV/AIDS care hospital in Fujian, China. Demographic data and laboratory data including gender, age, blood cell counts, biochemistry results, CD4 and CD8 cell counts, HIV-RNA loads, pathogen isolates, procalcitonin (PCT) levels and c-reactive protein (CRP) levels were collected. Continuous variables were expressed as median (range) and Kruskal-Wallis or Mann-Whitney test was used to analyze the differences between groups. Categorical data were expressed as numbers (percentage) and the differences between groups were analyzed by Pearson's chi-squared test.
In total, 3681 HIV inpatients with blood culture data were included and 683 strains identified from 646 inpatients were further analyzed. The median age of patients was 38 years and male accounted for 86.84%. The pooled prevalence of BSI was 18.55% (12.01%-22.36% during the six-year period). The overall isolated rate of (TM) in blood culture was 12.42% (8.3%-15.00% during the study period). TM was the persistent dominant BSI pathogen from 2015 to 2021 (accounting for 63.04% to 71.43%), followed by (responsible for 10.00% to 20.83%). Compared to patients with other organisms BSI, those with TM BSI were younger and had lower CD4 counts, WBC counts, HB and CRP level, but higher HIVRNA loads.
BSI is still a major problem in the post ART era in hospitalized patients with HIV/AIDS in Fujian, China. TM is the predominant pathogen. This underlines the importance of an early diagnosis of opportunistic pathogen to avoid BSI in HIV-infected populations with a low immune status.
本研究旨在调查抗逆转录病毒治疗（ART）时代过去6年福建省血流感染（BSI）的流行病学及病因谱。
开展一项回顾性观察性研究，纳入2015年9月至2021年8月期间在福建医科大学孟超肝胆医院住院的HIV阳性且血培养阳性患者，该医院是中国福建省最大的指定HIV/AIDS护理医院。收集人口统计学数据和实验室数据，包括性别、年龄、血细胞计数、生化结果、CD4和CD8细胞计数、HIV-RNA载量、病原体分离株、降钙素原（PCT）水平和C反应蛋白（CRP）水平。连续变量以中位数（范围）表示，采用Kruskal-Wallis或Mann-Whitney检验分析组间差异。分类数据以数字（百分比）表示，采用Pearson卡方检验分析组间差异。
共纳入3681例有血培养数据的HIV住院患者，对646例患者分离出的683株菌株进行进一步分析。患者的中位年龄为38岁，男性占86.84%。BSI的合并患病率为18.55%（六年期间为12.01%-22.36%）。血培养中（TM）的总体分离率为12.42%（研究期间为8.3%-15.00%）。TM是2015年至2021年持续占主导地位的BSI病原体（占63.04%至71.43%），其次是（占10.00%至20.83%）。与其他病原体引起BSI的患者相比，TM引起BSI的患者更年轻，CD4计数、白细胞计数、血红蛋白和CRP水平更低，但HIVRNA载量更高。
在中国福建省，BSI仍是HIV/AIDS住院患者ART时代后的一个主要问题。TM是主要病原体。这凸显了早期诊断机会性病原体以避免免疫状态低下的HIV感染人群发生BSI的重要性。
