Laboratory diagnosis research of AIDS combined with penicilliosis marneffei

doi:10.3969/j.issn.1673-8640.2014.04.010

Abstract

Abstract:

Objective　To investigate the laboratory diagnosis Methods　of acquired immune deficiency syndrome（AIDS） combined with penicilliosis marneffei（PSM）. Methods　A total of 257 AIDS patients were enrolled. Bone marrow and peripheral blood fungal dimorphic culture and bone marrow smear microscopy were performed for the detection of Penicillium marneffei（PM）. The data were analyzed retrospectively. Results　The 77 AIDS patients had PM， and the detection rate was 29.96%. A total of 74 patients were identified by bone marrow and peripheral blood fungal dimorphic culture， including 65 patients were positive in bone marrow， and 54 patients were positive in peripheral blood. A total of 33 patients were proved to be PM positive by bone marrow smear microscopy， including 30 patients showed positive in fungal dimorphic culture， and 3 patients showed negative but positive during therapeutic diagnosis. With the positivity of bone marrow fungal and peripheral blood fungal dimorphic culture as the good standard for PM diagnosis， the detection rate of PM by bone marrow fungal culture was 87.84%， which was significantly higher than the detection rate by peripheral blood fungal culture among AIDS patients（72.97%）. The 2 individual culture rates were significant statistically with the rate of dimorphic culture（P＜0.05）. The detection specificity for the diagnosis of PSM by bone marrow smear microscopy was 90.91%， and the sensitivity was 44.59%. Combined with bone marrow smear microscopy， the missing rate of dimorphic culture was 3.90%. Conclusions　The detection of PM by bone marrow and peripheral blood fungal dimorphic culture combined with bone marrow smear microscopy is significant in the diagnosis of AIDS combined with PM on time.

Key words: Penicillium marneffei, Bone marrow smear, Fungal dimorphic culture, Acquired immune deficiency syndrome

CLC Number:

R446.5

WEI Shanqiu, SU Guosheng, LAN Jiang, LUO Xiaolu.. Laboratory diagnosis research of AIDS combined with penicilliosis marneffei[J]. , 2014, 29(4): 339-341.

References

[1] Li X, Yang Y, Zhang X, et al.Isolation of Penicillium marneffei from soil and wild rodents in Guangdong, SE China [J].Mycopathologia, 2011, 172(6):447-451.
[2] Cao C, Liang L, Wang W, et al. Common reservoirs for Penicillium marneffei infection in humans and rodents, China[J]. Emerg Infect Dis, 2011,17(2):209-214.
[3] Liu D, Liang L, Luo Q,et al.Morphology of Penicillium marneffei under oxidative stress in vitro[J].Mycoses,2011,54(2):113-118.
[4] Ustianowski AP,Sieu TP,Day JN. Penicillium marneffei infection in HIV[J]. Curr Opin Infect Dis, 2008,21(1):31-36.
[5] Vu Hai V, Ngo AT, Ngo VH, et al. Penicilliosis in Vietnam: a series of 94 patients[J]. Rev Med Interne, 2010, 31(12):812-818.
[6] 梁林慧.桂西山区艾滋病患者真菌菌种分布及药敏分析[J].广东医学,2012, 33(1): 107-109.
[7] 唐志荣,陈杰,温里,等.艾滋病合并青霉菌病119例临床分析[J].中华传染病杂志,2010,28(9):570-572.
[8] Kaplan JE, Benson C, Holmes KH, et al. Guidelines for prevention and treatment of opportunistic infections in HIV-infected adults and adolescents: recommendations from CDC, the National Institutes of Health, and the HIV Medicine Association of the Infectious Diseases Society of America[J]. MMWR Recomm Rep, 2009, 58(RR-4):1-207.
[9] 莫让辉,唐小平,蔡卫平,等.艾滋病合并播散性马尔尼菲青霉菌病4l例临床分析[J].中国实用内科杂志,2006,26(24):1953-1955.
[10] 唐秀文,张晶. 2 350例艾滋病患者血液培养病原体和药敏结果分析[J].广西医学,2010,39(7):782-785.
[11] 陈万山,李凌华,胡凤玉,等. PCR技术在快速诊断艾滋病合并播散性马尔尼菲青霉菌病中的应用[J].中华实验和临床感染病杂志(电子版),2011,5(2):126-132.
[12] 梁义,尹琦,陈勇.血浆1,3-β-D-葡聚糖检测诊断播散性马尔尼菲青霉菌病的价值[J].中国基层医药,2010,17(18):2449-2451.
[13] 陈中举,李丽,张蓓,等.艾滋病并发马尔尼菲青霉菌感染的实验室诊断[J].现代检验医学杂志,2010,25(1):83-84.