Characteristics analysis of AIDS complicated with severe pneumonia

Abstract

Objective To investigate the characteristics and pathogenic characteristics of acquired immunodeficiency syndrome (AIDS) complicated with severe pneumonia. Methods The clinical data of patients with AIDS complicated with severe pneumonia who were hospitalized and treated in the First People′s Hospital of Linhai City from January 2016 to January 2018 were collected. The laboratory test results, imaging findings, distribution of pathogens, mixed infections of pathogens, treatment and outcomes were statistically analyzed. The influencing factors of the prognosis were tested by Fisher′s exact test, and Logsitic regression analysis was used for multivariate analysis. Results Among the 42 patients, the majority were male patients(90.48%), and most of them were 21 to 50 years old(78.57%), and the onset involved multiple systems. The CD4+ T lymphocyte count was less than 200/mm2 (100.0%) in the 42 patients, including 69.05% less than 50/mm2 and 73.81% of patients had albumin levels lower than 25 g/L. Chest CT showed multiple or diffuse distribution of increased density and ground glass opacity. Various strains of microorganisms were successfully isolated from 29 cases (69.05%), a total of 76 strains. The top three of pathogen spectrum were fungi (60.53%, 46/76), Gram negative bacteria (15.79%, 12/76) and Gram positive bacteria (10.53%, 8/76); 92.86% of the patients were infected with 2 or more kinds of pathogenic bacteria. In the 42 patients, 17 cases (40.48%) survived and 25 cases (59.52%) died. Univariate analysis showed that CD4+ T lymphocyte count<50 /mm2, the albumin level<25 g/L and mechanical ventilation were related to the prognosis of the disease. Multivariate Logstic regression analysis showed that the albumin level <25 g/L and mechanical ventilation were independent risk factors affecting the prognosis of the disease. Conclusions Fungal infection is the most common infection in patients with AIDS complicated with severe pneumonia, and 92.86% of them are accompanied by mixed infections. Low albumin level and mechanical ventilation are important risk factors influencing the prognosis. Key words: AIDS; Severe pneumonia; Etiology