嗜麦芽窄食单胞菌在临床标本中的检出及其耐药性

目的了解某医院嗜麦芽窄食单胞菌（Sma）在临床标本中的检出及其耐药现状，为防治Sma感染提供依据。方法回顾性分析该院2004-2009年临床各科送检标本分离的Sma临床和实验室资料。结果2004-2009年收集的53 811份临床标本共分离Sma 230株，总分离率0.43%；年度分离率6年上升了14倍（由2004年的0.06%上升至2009年的0.84%）。菌株检出以呼吸科（125株，54.35%）、60岁以上者（159株，69.13%）及痰标本（215株，93.48%）居多。药敏结果显示，Sma对氨苄西林、阿米卡星、氨曲南、庆大霉素、亚胺培南、美罗培南、头孢唑林、头孢西丁、头孢噻肟、头孢呋辛、头孢吡肟呈高度耐药(耐药率66.20%～100.00%)和多重耐药；对米诺环素、环丙沙星、左氧氟沙星、复方磺胺甲口恶唑、头孢他啶、哌拉西林/他唑巴坦、头孢哌酮/舒巴坦的耐药率为0.00%～23.08%。结论Sma在临床标本分离率的迅速升高以及对临床常用抗菌药物的高耐药率和多重耐药性给Sma感染的防治带来巨大困难，应引起临床的高度关注。

Detection and drug resistance of Stenotrophomonas maltophilia isolated from clinical samples

Objective To realize the detection and drug resistance of Stenotrophornonas rnaltophilia （Sma） isolated from clinical samples, so as to provide evidence for preventing and treating Sam infection. Methods Clinical and laboratory data of 230 Sma strains isolated from clinical departments between 2004 and 2009 was analysed retrospectively. Results 230 strains of Sma were isolated from 53 811 clinical samples, the total isolation rate was 0. 43%; The annual isolation rate increased by 14-fold within 6 years（from 0. 06% in 2004 to 0. 84% in 2009）. The detection rates were high in patients in respiratory department（125 isolates, 54. 35%）, old patients aged ≥60 （159 isolates, 69. 13%）, and sputum sample （215 isolates, 93.48%）. Antimicribial susceptibility test results showed that Sma was highly and multiply resistant to ampicillin, amikacin, aztreonam, gentamicin, imipenem, meropenem, cefazol in, cefoxitin, cefotaxime, cefuroxime, and cet＇epime, the resistant rates was between 66. 20% and 100. 00% ; The resistant rates to minocycline, ciprofloxacin, levofloxacin, sulfamethoxazole/trimethoprim, ceftazidime, piperacillin/tazobactam and cefoperazone/sulbaetam was between 0. 00% and 23. 08%. Conclusion The rapid increase in isolation rate of Sma from clinical samples and multiple drug-resistance to commonly used antimicrobial agents can bring about enormous difficulty to the prevention and treatment of infection, which should pay high attention.