海南类鼻疽临床流行病学研究报告

目的了解海南类鼻疽病流行病学特点、临床特征、耐药性、治愈率、抗菌药物使用情况。方法采用回顾性分析方法对45例类鼻疽病病例的流行病学特点、临床表现、特征以及耐药性、抗菌药物使用情况进行统计分析。结果类鼻疽病在海南以散发为主,三亚及周边城镇发病率明显较高。好发于多雨的秋冬季节,接触疫水或土壤、糖尿病、肝肾功能不全、低蛋白血症、贫血、年龄>46岁等为易感因素。感染以败血症多见,肺部易受累,多伴有多种基础性疾病或危险因素。随着碳青霉烯类抗菌药物的广泛使用,类鼻疽伯克霍尔德菌对亚胺培南耐药率达17.8%,对美罗培南及哌拉西林他唑巴坦最为敏感。结论类鼻疽病在海南地区的流行趋势增加不容忽视,了解该病诊疗情况,尽早进行细菌培养尤其是血培养,选择敏感抗菌药物且足剂量、足疗程、个体化是治疗的关键。

Clinical epidemiologic research of melioidosis in Hainan

Objective To investigate the epidemiological characteristics, clinical symptoms, drug resistance, curative rate and antibiotics use of melioidosis in Hainan. Methods The epidemiological characteristics,clinical symp-toms,drug resistance,curative rate and antibiotics use of 45 cases of melioidosis were analyzed retrospectively. Results Melioidosis in Hainan was mainly sporadic,and the morbidity was comparatively higher in Sanya city and surround-ing towns. Melioidosis usually occured in rainy fall and winter,and the normal predisposing factors were contacting epi-demic water or soil,diabetes,damaged liver or kidney functions,hypoproteinemia,anemia,being older than 46 years old and so on. The common infection in melioidosis was septicaemia and the lung was the major organ being destroyed, which was often complicated with multiple basic diseases or risk factors. With the wide use of carbopenems,the resist-ance rate of Burkholderia pseudomallei to imipenem was 17. 8%,and was most sensitive to meropenem and piperacil-lin/tazobactam. Conclusion The wide spread tendency of melioidosis in Hainan can′t be ignored. The keys to treat-ment are to understand the diagnosis and treatment of the disease and make bacterial culture,especially blood culture as early as possible,and to use sensitively antibiotics with enough dosage,adequate duration in individualized treatment.