128株嗜麦芽窄食单胞菌在院内感染中的耐药性分析

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,提高临床对嗜麦茅窄食单胞 菌防治水平。方法 对128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。列第二 位;药敏试验表明:该菌广泛耐药,敏感率>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,嗜麦芽窄食单胞对多种抗生素耐药,一旦感染,治疗颇为困难。

Analysis of Antimicrobial Resistance of 128 Stenotrophomonas Maltophilia among Nosocomial Infection

objective To investigate the Infectious risks and resistant characteristics of Stenotrophomonas maltophilia, and improve the level of clinical prevention and therapy of Stenotrophomonas maltophilia infection. Methods The antimicrobial resis- tance of of 128 strains of Stenotrophomonas maltophilia were determined by standard Kirby-Bauer method according with guidelines of NCCLS(2000). The clinical data about the 128 Stenotrophomonas maltophilia-infection were analyzed. Results Among the nonfermenting Gram-negative bacilli strains were isolated from our hospital, the most predominant pathogens of them was 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, were the active agents against Stenotrophomonas maltophilia with susceptibility rates 50.0% or more. Among the patients with Stenotrophomonas maltophilia infection, approximately to 90.3% of them had basic clinical disease, 97. 0% of them had ever treated with extend-spectrum antibiotics,75.7% of them were treated with invasive examination or therapy. Conclusion Stenotrophomonas maltophilia is becoming to the most predominant pathogens in nosocomial infection, which is easy to infect these immunopromised patients with aged, some chronic diseases, hormone treatment, long periods of antibiotoics therapy and invasive examination or therapy. Multi-drug resistance of Stenotrophomonas maltophilia is a serious problem in clinical therapy. An effective strategy for solving this problem is urgently needed.