2011年中国CHINET嗜麦芽窄食单胞菌耐药性监测

目的了解国内不同地区15所医院2011年临床分离嗜麦芽窄食单胞菌对抗菌药物的敏感性。方法收集15所医院2011年临床分离嗜麦芽窄食单胞菌1889株，按统一方案及材料、采用纸片扩散法或自动化仪器法进行细菌药敏试验，按照CLSI2011年标准判读结果。结果监测的1889株嗜麦芽窄食单胞菌主要分离自住院患者，占93．3％；门诊患者分离株占6．7％。60岁及以上的老年患者分离株占62．9％，小于18周岁患者的分离株占8．2％。痰液等呼吸道分泌物是陔菌的主要分离源，占82．6％；分离自血液、胸腹水、关节腔液、脑脊液等无菌体液菌株占4．2％。该菌对甲氧苄啶-磺胺甲口恶唑、左氧氟沙星和米诺环素的耐药率分别为16．6％、10．0％和1．8％，对头孢哌酮-舒巴坦的耐药率为19．0％。血液及无菌体液分离株对甲氧苄啶-磺胺甲口恶唑的耐药率为37．1％，高于其他标本分离株，与伤口及尿液标本比较，P值〈0．01。结论嗜麦芽窄食单胞菌主要分离自住院患者及其痰液等呼吸道标本中，且60岁以上的老年患者多见。该菌对多种抗菌药物固有耐药，但对CL sI推荐的甲氧苄啶-磺胺甲口恶唑、左氧氟沙星和米诺环素的耐药率低。头孢哌酮舒巴坦对该菌亦有抗菌活性。应以药敏试验结果合理选用治疗嗜麦芽窄食单胞菌感染的抗菌药物。

CHINET 2011 surveillance of antibiotic resistance in Stenotrophomonas malto- philia in China

Objective To investigate the resistance of clinical Stenotrophomonas maltophilia isolates from 15 hospitals in several regions of China during 2011. Methods Fifteen repre sentative general hospitals were involved in this program. Bacterial suseeptibility testing was carried out by means of a unified protocol using Kirby-Bauer method and MIC determi nation. Results were analyzed according to CI.SI 2011 break points. Results Majority （93. 30/oo） of the 1 g89 clinical strains of S. maltophilia were isolated frominpatients. （）nly 6.7o/00 of the isolates were from outpatients. About 62.9~ of these S. maltophilia strains were isolated from old patients whose age was 60 years or older. Only 8.2% of the strains were from the patients younger than 18 years old. Sputum and re- spiratory tract secretion were the most common specimen source, accounting for 82. 6%. Another 4. 2% isolates were from blood, abdominal fluid and other sterile body fluids. The percentage of the S. maZtophilia strain resistant to trimethoprim-sul famethoxazole, levofloxacin and minocycline was 16.6%, 10.0% and 1.8% , respectively. The strains resistant to cefopera- zone-sulbactam accounted for 19.0%. About 37.1 ~//00 of the strains isolated from blood or sterile body fluids were resistant to trimethoprim-sulfamethoxazole, significantly higher than the strains from urine or wound specimens （P-~ 0.01）. Conclusions S. maltophilia strains are mainly isolated from inpatients. The most common source is sputum and other respiratory speci- mens. Most of the patients with S. maltophilia isolate are 60 years of age or older. The S. maltophilia strains are constitu- tively resistant to several antibacterial agents, but showed relatively lower resistance to trimethoprim-sulfamethoxazole, levo- floxacin and minocycline. Cefoperazone-sulbactam is still active against these strains. The antimicrobial therapy targeting S. maltophilia infections should be selected cautiously according to the results of antimicrobial resistance surveillance.