何建方, 沈翠芬, 张晓祥, 王伟洪, 童照威, 叶勇. 1702株嗜麦芽寡养单胞菌感染的分布特征及耐药性分析[J]. 疾病监测, 2011, 26(10): 805-808.
引用本文: 何建方, 沈翠芬, 张晓祥, 王伟洪, 童照威, 叶勇. 1702株嗜麦芽寡养单胞菌感染的分布特征及耐药性分析[J]. 疾病监测, 2011, 26(10): 805-808.
HE Jian-fang, SHEN Cui-fen, ZHANG Xiao-xiang, WANG Wei-hong, TONG Zhao-wei, YE Yong. Distribution and drug resistance of 1702 strains of Stenotrophomonas maltophilia[J]. Disease Surveillance, 2011, 26(10): 805-808.
Citation: HE Jian-fang, SHEN Cui-fen, ZHANG Xiao-xiang, WANG Wei-hong, TONG Zhao-wei, YE Yong. Distribution and drug resistance of 1702 strains of Stenotrophomonas maltophilia[J]. Disease Surveillance, 2011, 26(10): 805-808.

1702株嗜麦芽寡养单胞菌感染的分布特征及耐药性分析

Distribution and drug resistance of 1702 strains of Stenotrophomonas maltophilia

  • 摘要: 目的 了解嗜麦芽寡养单胞菌的分布特征及9年间耐药性的变迁,为临床治疗提供参考。 方法 回顾性分析2002-2010年浙江省湖州市中心医院各类临床标本分离出的嗜麦芽寡养单胞菌的分离率、分布特点及药敏结果。 结果 9年共检出嗜麦芽寡养单胞菌1702株,分离率为6.9%。标本来源以痰液为主,占92.1%。科室分布以重症监护室最多,占38.8%,其次是脑外科和呼吸内科,分别占31.1%和18.4%。嗜麦芽寡养单胞菌对复方氨苄西林、亚胺培南、妥布霉素、庆大霉素完全耐药,对替卡西林、哌拉西林、哌拉西林/他巴唑、头孢吡肟、美罗培南、阿米卡星也近乎完全耐药,其耐药率分别为99.5%、99.8%、99.2%、95.2%、96.1%和99.6%,对多粘菌素E、环丙沙星的耐药率为78.6%和60.8%,对替卡西林/棒酸、头孢他啶、左氧沙星的耐药率50%,分别为43.4%、42.2%和24.4%,而对头孢哌酮/舒巴坦、复方磺胺甲恶唑、米诺环素均保持较好的药物敏感性,其耐药率仅为10.1%、6.2%和0.9%。 结论 嗜麦芽寡养单胞菌感染呈逐年上升趋势,主要引起呼吸道系统的感染,对多种抗菌药物完全耐药。临床应高度重视该菌所致感染,依据药敏结果合理选用抗菌药物,并采取相应的院感干预措施,控制耐药菌株的院内扩散。

     

    Abstract: Objective To understand the distribution characteristics and the change in drug resistance of Stenotrophomonas maltophilia in the past 9 years and provide reference for the clinical treatment. Methods The retrospective analysis was conducted on the isolation rate of Stenotrophomonas maltophilia; the infection distribution and the drug resistance of isolated strains in our hospital from 2002 to 2010. Results A total of 1702 strains of Stenotrophomonas maltophilia were isolated during this period, the isolation rate was 6.9%. The main clinical specimens were sputum, accounting for 92.1%. Stenotrophomonas maltophilia infection were mainly detected in ICU wards (38.8%), neurosurgery department (31.1%) and pneumology department (18.4%). The result of drug susceptibility test showed that the resistance rates of Stenotrophomonas maltophilia to compound ampicillin, imipenem, tobramycin and gentamicin were 100%. The resistance rate of Stenotrophomonas maltophilia was 99.5% to ticarcillin, 99.8% to piperacillin, 99.2% to piperacillin/tazobactam, 95.2% to cefepime, 96.1% to meropenem, 99.6% to amikacin, 78.6% to polymyxin, 60.8% to ciprofloxacin, 43.4% to ticarcillin/clavulanic, 42.2% to ceftazidime and 24.4% to levofloxacin, but the isolated strains of Stenotrophomonas maltophilia were highly sensitive to cefoperazone/sulbactam, compound sulfamethoxazole and minocycline. Conclusion The isolation rate of Stenotrophomonas maltophilia was in increase. Stenotrophomonas maltophilia mainly caused respiratory tract infection and showed serous drug resistance to many kinds of antibiotics. It is necessary for hospitals to monitor its drug resistance, choose antibiotics reasonably and strengthen control of hospital infection to prevent the spread of multidrug-resistant Stenotrophomonas maltophilia.

     

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