摘要
目的了解北京地区6所医院嗜麦芽寡养单胞菌感染的危险因素及耐药特征,并探讨不同来源菌株耐药率间的差别。方法对145株嗜麦芽寡养单胞菌感染临床资料进行统计分析和药敏试验,协同过筛法检测金属β-内酰胺酶(MBL)。结果145株嗜麦芽寡养单胞菌的标本来源以痰标本为主,占86.2%,其临床分布以ICU(48.3%)和呼吸科(22.1%)为主;该菌对常用抗菌药物耐药,敏感性>50.0%的抗菌药物依次为多西环素、加替沙星、头孢哌酮/舒巴坦、左氧氟沙星、复方新诺明、头孢他啶/克拉维酸、替卡西林/克拉维酸;各医院的感染菌株对部分抗菌药物的耐药性存在差异;在感染患者中,56.7%患有基础疾病,92.2%先期使用过广谱抗菌药物,76.8%接受侵入性检查和治疗。结论嗜麦芽寡养单胞菌耐药性严重,多发生于有各种基础疾病、免疫力低下的患者,治疗应根据药敏试验结果合理选用抗菌药物。
OBJECTIVE To analyze the risk factors and antimicrobial resistance pattern of Stenotrophomonas maltophilia isolated from 6 hospitals in Beijing, and study the difference in resistance rate of isolates from different hospitals. METHODS In this study, 145 cases with S. maltophilia infection were analyzed and their susceptibility was tested. The synergetic screening test was applied to detect metallo-β-lactamases. RESULTS Most of 145 strains were isolated from sputum（86. 2%）, mainly from ICU （48. 3%）, and department of respiratory medicine（22.1%）. The drug sensitivity tests in vitro showed these strains were resistant to commonly used antibiotics, and drugs whose sensitive rate was over 50% included doxycycline, gatifloxacin, cefoperazonesulbactam, levofloxacin, compound sulfamethoxazole, ceftazidime-clavulanate and ticarcillin-clavulanate. The antimicrobial resistance of strains isolated from different wards showed some difference. Of all the infected patients, 56.7% had underlying diseases; 92.2% were treated previously with broad-spectum antibiotics; 76.8% underwent invasive examination or treatment. CONCLUSIONS S. maltophilia is resistant to many kinds of antibiotics. The infection caused by S. maltophilia often occurs in patients with severe underlying disease and low immunity. Antibiotics should by chosen by drug sensitivity tests.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2007年第4期462-464,共3页
Chinese Journal of Nosocomiology
基金
北京科委重大培育专项基金(20005190041891)
