Abstract: Objective To investigate the immune status, flora distribution and their resistance of intestinal pathogenic bacterium in patients with AIDS-related chronic diarrhea, and to provide a basis for clinical medication selection. Methods A total of 381 AIDS patients with chronic diarrhea who hospitalized in Longtan Hospital of Guangxi Zhuang Autonomous Region from January 2016 to October 2020 were collected for flora analysis and drug sensitivity. Further, these patients were evaluated immune status by analyzing the contents of CD4⁺T and CD8⁺T lymphocytes. To compare the immune status of AIDS patients with chronic diarrhea, 400 AIDS patients who without opportunistic infection were enrolled into the control group to assess immune status via performing flow cytometry as well. Results There were 357 cases found fungi in excrement, the types of fungi including183 cases of Candida albicans (51.26%); 100 cases of Candida glabrata (28.01%); 37 cases of Candida tropicalis (10.66%); 24 cases of Candida krusei (6.72%); 13 cases of Candida paraglabrata (3.64%); among of these fungus infection patients, some of them simultaneously infected with bacterial, there were 18 cases (4.72%) with intestinal Mycobacterium infection and6 cases (1.57%) with intestinal Salmonella infection. In the cases of fungal infection, the sensitivity of each fungus to amphotericin B, fluconazole, itraconazole, voriconazole and 5-fluorouracil was significant difference (P<0.05). Candida albicans infection is the most common and is sensitive to all five antifungal drugs. The drug resistance rate of those with tubercle bacillus cultured in stool was 38.89%~66.67%. The susceptibility to commonly used antibiotics in feces cultured with Salmonella infection was 30.33%~100.00%. AIDS patients with an intestinal bacterial infection will have lower contents of immune cells than without intestinal infection. The results of flow cytometry showed that CD4⁺T lymphocytes 33.00(10,90) /μl, CD8⁺T lymphocytes 351.00(201,577)/μl, and CD4⁺T/CD8⁺T 0.11 (0.04,0.22) for test group. Control group CD4⁺T lymphocytes 222.00(125,334)/μl, CD8⁺T lymphocytes 744.00(524,1144)/μl, CD4⁺/CD8⁺ 0.28(0.16,0.43), two groups of CD4⁺T, CD8⁺T lymphocytes and CD4⁺T/CD8⁺T were significantly different (P<0.01). Conclusion The weakened immunity of AIDS patients leads to intestinal barrier dysfunction, bacterial translocation, imbalance of intestinal flora, and ultimateintestinalinfection. And the choice of antibacterial drugs should base on drug sensitivity and ensure the treatment efficacy.

Key words: Acquired immune deficiency syndrome, Chronic diarrhea, Intestinal infection, Drug resistant, Treatment