嗜麦芽寡养单胞菌的临床分布及耐药性分析

目的调查分析我院住院患者嗜麦芽寡养单胞菌的临床分布及耐药状况,为临床预防和治疗嗜麦芽寡养单胞菌感染及医院感染控制提供依据。方法收集2013年1月一2017年12月我院住院患者送检的各类标本分离出的嗜麦芽寡养单胞菌,采用微生物鉴定仪进行细菌鉴定和药敏试验,并做临床常用抗生素耐药性分析,应用WHONET5.6软件对药敏结果进行分析,SPSS17.0统计分析,5年耐药率变化用x检验。结果共检出嗜麦芽寡养单胞菌873株,主要分离痰液标本,占58.9%,其次是尿液和伤口分泌物,分别占11.0%和8.2%;主要来源于重症监护病房(ICU)、急诊科和呼吸内科,分别占29.3%、23.1%和9.4%。5年间对米诺环素、复方磺胺甲愿唑和左氧氟沙星敏感率高,敏感率依次为94.3%、86.9%和75.6%。在分离的嗜麦芽寡养单胞菌抗菌药物中,米诺环素和左氧氟沙星的耐药率均无统计学意义(P>0.05)。结论分离的嗜麦芽寡养单胞菌耐药率高,治疗难度大。临床应以药敏结果选用抗生素,防止菌株产生耐药和流行。同时,临床医生对感染嗜麦芽寡养单胞菌的患者经验用药可首选米诺环素和左氧氟沙星。

Analysis of distribution and drug resistance of Stenotrophomonas maltophilia

Objective To investigate the distribution and drug resistance of Stenotrophomonas maltophilia, aiming to provide guidelines for the clinical prevention and treatment of Stenotrophomonas maltophilia and control of nosocomial infection. Methods Stenotrophomonas maltophilia was isolated in our hospital from Jan 2013 to Dec 2017. The drug sensitivity test was performed by microscan microbial identification and subjected to antibiotic resistance analysis. WHONET 5.6 was applied for the analysis of the sensitive data. SPSS 17.0 software was used for the statistical analysis. Five year trend of drug resistance rate was analyzed by chi square test. Results 873 Strains of Stenotrophomonas maltophilia were isolated. Most of the Stenotrophomonas maltophilia were mainly isolated from sputum specimens (58.9%), urine (11.0%) and wound secretion (8.2%), and mostly distributed in intensive care unit (29.3%), emergency department (23.1%) and respiratory department (9.4%). Stenotrophomonas maltophilia was sensitive to minocycline (94.3%), compound sulfamethoxazole (86.9%) and levofloxacin (75.6%), and the resistance rate was less than 15% in the 5 years. The resistance rates against minocycline and levofloxacin showed no statistically significant differences (P>0.05). Conclusion The isolates of Stenotrophomonas maltophilia were highly resistant to the commonly used antibiotics. Therefore, the rational use of antibiotics to Stenotrophomonas maltophilia should be strengthened to prevent the generation and prevalence of multi-drug resistant strains in hospitalized patients.Meantime, the clinician can choose minocycline and levofloxacin as the experience drugs to treat for patients infected with Stenotrophomonas