嗜麦芽窄食单胞菌的临床分布及耐药性分析

目的调查我院住院患者嗜麦芽窄食单胞菌的临床分布及耐药性变迁,为临床医师合理使用抗菌药物提供依据。方法收集2014年1月至2016年12月我院住院患者送检的各类标本分离出的嗜麦芽窄食单胞菌,采用VITEK-2系统进行细菌鉴定和药敏试验,并对阳性标本的耐药性进行分析。结果共检出嗜麦芽窄食单胞菌207株,感染嗜麦芽窄食单胞菌的易感人群以中老年患者为主;主要分离自痰标本,占60.4%,其次是尿和全血,分别占13.0%和7.7%;主要来源于重症监护病房和神经内科病房,分别占16.4%和13.5%。在CLSI判定标准规定的针对嗜麦芽窄食单胞菌的几种抗菌药物中,耐药率较低的抗菌药物为复方新诺明和左氧氟沙星,敏感率分别为89.4%、72.5%。结论住院患者嗜麦芽窄食单胞菌的耐药率高,治疗难度大,感染的易感人群主要以中老年患者为主,临床医生应根据药敏试验结果合理选用抗菌药物,避免多重耐药嗜麦芽窄食单胞菌菌株的产生和流行。

Analysis of distribution and drug resistance of stenotrophomonas maltophilia

Objective To explore the changes of drug resistance of Stenotrophomonas maltophilia and to provide evidence for rational use of antibiotics.Methods Stenotrophomonas maltophilia isolated in our hospital from Jan 2014 to Dec 2016 were collected and the drug sensitivity test was performed by the VITEK 2 compact,and at the same time,the results of the drug sensitivity test were analyzed.Results 207 strains of Stenotrophomonas maltophilia were isolated,most of the Stenotrophomonas maltophilia strains were isolated from middle-aged and elderly patients in our hospital.Stenotrophomonas maltophilia was mainly isolated from sputum specimens (60.4％),followed by urine (13.0％) and blood (7.7％),the main sources were in ICU (16.4％) and department of neurology (13.5％),The highest susceptibility rates of the isolations were to SMZ (89.4％),followed by levofloxacin (72.5％).Conclusion The isolations of Stenotrophomonas maltophilia in hospitalized patients are highly resistant to the commonly used antibiotics.Therefore,The rational use of antibiotics to Stenotrophomonas maltophilia in hospitalized patients should be strengthened to avoid the generation and prevalence of multi drug resistant strains.