摘要
目的了解诺卡菌感染的临床特点、标本类型及耐药性,为临床合理应用抗菌药物提供依据。方法回顾性分析医院2012年1月-2017年3月细菌培养分离的诺卡菌,分析其菌种分布、标本来源、临床特点及药敏结果,使用16SrRNA扩增测序鉴定菌种,体外药敏试验采用微量肉汤稀释法。结果共收集诺卡菌15株,包含三种诺卡菌,分别为盖尔森基兴诺卡菌、鼻疽诺卡菌、豚鼠耳炎诺卡菌,各占66.7%、20.0%、13.3%;标本来源以痰液为主,占46.5%,其次为静脉血,占20.0%;患者呼吸系统、皮肤、中枢神经系统均有受累,临床表现以肺部感染为主,主要表现为咳嗽、咳痰、发热;诺卡菌对环丙沙星耐药率最高,为80.0%,其次为庆大霉素,为26.7%;所有菌株对阿米卡星、克拉霉素、利奈唑胺、磺胺甲唑/甲氧苄啶100.0%敏感,对亚胺培南、米诺环素等均表现较高的敏感性。结论诺卡菌对利奈唑胺、大环内酯类及磺胺类药物均有较高的敏感性,但对喹诺酮类药物敏感性较低,应加强药物检测,为临床合理使用抗菌药物及医院感染的有效控制提供理论依据。
OBJECTIVE To investigate the clinical characteristics of Nocardia infection,specimens sources and drug resistance so as to provide guidance for reasonable clinical use of antibiotics.METHODS The Nocardiastrains that were isolated from Jan 2012 to Mar 2017 were retrospectively analyzed,the distribution of species,specimens sources,clinical characteristics and results of drug susceptibility testing were observed,the strains were amplified,sequenced and identified by using 16 SrRNA,and the in vitro drug susceptibility testing was performed with the use of micro broth dilution method.RESULTS Totally 15 strains of Nocardia were collected,including 3 species,66.7% of which were Nocardia cyriacigeorigica,20.0% were Nocardia farcinica,and 13.3% were Nocardia otitidiscaviarum.Of the specimens sources,46.5% were sputum specimens,and 20.0% were venous blood specimens.The respiratory system,skin and central nervous system were involved,the pulmonary infection was the major clinical manifestation and was characterized by cough,expectoration and fever.The drug resistance rate of the Nocardiastrains to ciprofloxacin was the highest（80.0%）,followed by gentamicin（26.7%）.The drug susceptibility rates of all the strains to amikacin,clarithromycin,linezolid and sulfamethoxazole-trimethoprim were 100.0%,and the strains were highly susceptible to imipenem and minocycline.CONCLUSION The Nocardia strains are highly susceptible to linezolid and macrolides as well as sulfonamides but are less susceptible to quinolones.It is necessary to strengthen the surveillance of drug resistance so as to provide theoretical bases for reasonable clinical use of antibiotics and control of nosocomial infection.
作者
程振娜
李刚
殷国民
周晓燕
赵梅
马红
贾伟
CHENG Zhen-na＂ , LI Gang, YIN Guo-min, ZHOU Xiao-yan, ZHAO Mei, MA Hong, JIA Wei(Clinical College ,Ningacia Medical University,Yinchuan, Ningxia 750004, Chin)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2018年第6期818-821,共4页
Chinese Journal of Nosocomiology
基金
宁夏医科大学重点研究基金重点资助项目(XZ2016007)
关键词
诺卡菌属
细菌鉴定
临床表现
耐药性分析
Nocardia
Bacterial identification
Clinical manifestation
Drug resistance analysis
