256株嗜麦芽窄食单胞菌的耐药性分析

目的研究嗜麦芽窄食单胞菌的感染危险因素及其耐药特征,提高临床对嗜麦芽窄食单胞菌防治水平。方法对256例嗜麦芽窄食单胞菌感染者的临床资料进行统计分析,并用纸片扩散（K-B）法测其耐药情况。结果嗜麦芽窄食单胞菌占非发酵革兰阴性杆菌23.0%,居铜绿假单胞菌之后,列第2位;药敏试验表明该菌广泛耐药,敏感率大于50%者仅有复方新诺明、替卡西林/克拉维酸与头孢哌酮/舒巴坦;在感染患者中,有90.3%患有基础病,97.0%先期使用过广谱抗生素,75.7%曾接受侵入性检查和治疗。结论嗜麦芽窄食单胞菌已成为医院内感染重要致病菌之一,多发生在免疫功能低下的老年、慢性疾病、接受激素及长期抗菌药物治疗的患者,施行各种侵入性检查和治疗的患者也是感染的高危人群,嗜麦芽窄食单胞菌对多种抗生素耐药,一旦感染,治疗颇为困难。

Analysis of the antimicrobial resistance of 256 strains of stenotrophomonas Maltophilia

Objective To investigate the infectious risks and resistant furtures of stenotrophomonas maltophilia,and improve the level of clinical prevention and therapy of stenotrophomonas maltophilia infection. Methods The antimicrobial resistance of 256 strains of strains of stenotrophomonas maltophilia were determined by standard Kirby- Bauer method according to the guidelines of NCCLS（2002）, and simultaneously, the clinical data about the 256 stenotrophomonas maltophilia infection were analyzed. Results Among the nonfermenting, Gram negative bacilli strains were isolated from the patients of our hospital,the most predominant pathogens of whom were Pseudomonas aeruginosa, followed by Stenotrophomonas maltophilia （23.0%）. Most of isolates were extensive drug resistance. There are only several antibiotics, including sulfanilamide, Ticarcillin/Clavulanic acid, and Cefoperazone/sulbactam, which were the active agents against stenotrophomonas maltophilia with susceptibility rates of 50.0% or more. A- mong the patients with stenotrophomonas maltophilia infection,approximately 90.3 % of them had basic clinical disease,97.0% of them were once treated with extend spectrum antibiotics,75.7% of them were treated with invasive examination or therapy. Conclusion Stenotrophomonas maltophilia is becoming one of the most predominant pathogens in nosocomial infection, which is easy to infect the aged and immunopromised patients with chronic diseases, hormone treatment,long periods of antibiotoics therapy and invasive examination. Multi-drug resistance of stenotrophomonas maltophilia is a serious problem in clinical therapy. An effective strategy for solving this problem is urgently needed.