嗜麦芽窄食单胞菌感染的临床及药物敏感试验分析--附247株检测报告

目的:分析和总结247株嗜麦芽窄食单胞菌的感染情况和对抗菌药的耐药情况,为临床预防和治疗该菌引起的感染提供依据.方法:对临床标本中分离的247株嗜麦芽窄食单胞菌进行细菌鉴定和药敏试验,复习有关临床资料,分析发病的危险因素.结果:247株嗜麦芽窄食单胞菌的检出标本以痰为主,占92.3%;居检出临床科室前4位的依次为ICU(32.4%)、呼吸科(17.4%)、神经内科(14.6%)、神经外科(12.1%);高龄、侵入性诊疗操作、使用广谱抗菌药为嗜麦芽窄食单胞菌感染的危险因素,分别占77.3%、65.2%、100%;该菌对常用抗菌素耐药,敏感率超过50%的抗菌药依次为左氧氟沙星(84.4%)、头孢哌酮钠-舒巴坦(77.3%)、替卡西林-克拉维酸钾(76.9%)、复方磺胺甲噁唑(55.9%).结论:嗜麦芽窄食单胞菌感染多发生在有各种基础疾病、免疫力低的患者,该菌耐药现象严重,治疗应根据药敏试验结果合理选用抗菌药.

Analysis of clinical characteristics and drug sensitivity tests of infection with stenotrophomonas maltophilia

Objective: To analyse the situation of epidemic and antibiotic resistance of Stenotrophomonas maltophilia in order to provide basis for the prevention and treatment of the infection indused by the bacterium. Methods: 247 strains of Stenotrophomonas maltophilia from clinical isolates were identified and their susceptibility was tested.Clinical data were reviewed, and risk factors were analysized. Results:Most of 247 strains were isolated from sputum(92.3%).247 strains were mainly isolated from ICU(32.4%), department of respiratory medicine (17.4%), department of neurology(14.6%),and department of neurosurgery(12.1%).Risk factors was old age, invasive procedures and the use of broad spectrum antibiotics,account for 77.3%,65.2% and 100% respectively. The drug sensitivity tests in vitro showed that these strains were resistant to commonly used antibiotics, and drugs whose sensitive rate was over 50% included levofloxacin (84.4%), cefoperazone-sulbactam(77.3%),ticarcillin-clavulanate(76.9%),and SMZ-TMP(55.9%).Conclusion:The infection caused by Stenotrophomonas maltophilia often occur in patients with severe underlying diseases and low immunity. Stenotrophomonas maltophilia is resistant to many kinds of antibiotics. Antibiotics should be chosen by drug sensitivity tests.