嗜麦芽寡养单胞菌所致医院感染及危险因素分析

目的了解嗜麦芽寡养单胞菌医院感染现状及相关危险因素。方法将临床分离引起医院感染的嗜麦芽寡养单胞菌30株,经VITEK-Ⅱ微生物鉴定系统重新鉴定,微量肉汤稀释法监测14种抗菌药物的最低抑菌浓度（MIC）;1∶1病例对照研究,Logistic多因素回归分析筛选出导致该菌感染的危险因子。结果30株嗜麦芽寡养单胞菌对亚胺培南、美罗培南、头孢噻肟、氨曲南、阿米卡星高度耐药;但对头孢哌酮/舒巴坦、哌拉西林/他唑巴坦、复方新诺明、替卡西林/克拉维酸仍保持一定敏感性,敏感率分别为96.7%、76.7%、73.3%、60.0%;独立危险因素为机械通气（OR=7.629）和住院时间〉60 d（OR=4.466）。结论嗜麦芽寡养单胞菌对常用抗菌药物呈多重耐药,机械通气和住院时间〉60 d是嗜麦芽寡养单胞菌医院感染的独立危险因素。

Nosocomial Infections Caused by Stenotrophomonas maltophilia: Conditions and Associated Risk Factors

OBJECTIVE To investigate the conditions and associated risk factors of nosocomial infections caused by Stenotrophomonas maltophilia.METHODS Thirty isolates of S.maltophilia causing nosocomial infections were collected and identified with API 20NE test strips.Minimal inhibitory concentration(MIC) of 14 antimicrobial agents against 30 isolates was determined by broth microdilution method.Case-control study and multivariate Logistic regression analysis were used for statistics to verify risk factors of infections caused by S.maltophilia.RESULTS Thirty isolates of S.maltophilia were highly resistant to imipenem,meropenem,cefotaxime, aztreonam and amikacin,but showed certain susceptibility to cefoperazone/sulbactam,piperacillin/tazobactam,trimethoprim-sulfamethoxazole and ticarcillin/clavulanic acid(96.7%,76.7%,73.3% and 60.0%,respectively).The independent risk factors leading to infections of S.maltophilia were mechanical ventilation(OR=7.629) and over 60 days of length of stay(OR=4.466).CONCLUSIONS S.maltophilia shows multiresistance to commonly used antimicrobial agents.The mechanical ventilation and over 60 days of length of stay are the independant risk factors for nosocomial infections caused by S.maltophilia.