嗜麦芽窄食单胞菌下呼吸道感染28例分析  

Analysis of Clinical Characteristics of Lower Respiratory Tract Infection by Stenotrophomonas Maltophilia in 28 Cases

作　　者：王燕[1] 杨玉[2] 洪茜萍[3] 陈哲[1] 

机构地区：[1]天津医科大学总医院呼吸科,300052 [2]河北省玉田县医院内科 [3]天津医科大学总医院儿科,300052

出　　处：《天津医药》2004年第11期668-670,共3页Tianjin Medical Journal

摘　　要：目的:了解嗜麦芽窄食单胞菌下呼吸道感染的致病特点和对抗菌药物的敏感性。方法:分析28例嗜麦芽窄食单胞菌下呼吸道感染住院患者的临床特点、细菌培养及药敏试验。结果:嗜麦芽窄食单胞菌下呼吸道感染的发病率较前增高,多发生于高龄老年(82.14%),免疫功能低下、有多种基础病的患者(89.29%),大多数有应用糖皮质激素史(57.14%),全部患者有多种抗生素应用史,院内感染发病率高(46.43%);临床病情重,病死率高(28.57%)。该菌对亚胺培南耐药,多数头孢菌素、氨基糖苷类、氨曲南及部分青霉素类耐药率也很高。对左氧氟沙星、环丙沙星、替卡西林/克拉维酸、TMP-SMZ及美洛西林的敏感率在56.25%以上。结论:嗜麦芽窄食单胞菌下呼吸道感染的临床症状重,其对大多数抗菌药物耐药是其治疗难度增加及病死率高的原因之一。Objective: To analyze clinical characteristics of lower respiratory tract infection caused by Stenotrophomonas maltophilia and to study the antibiotics sensitivity in Stenotrophomonas maltophilia. Methods: We retrospectively studied the clinical characteristics and analyzed data of sputum culture of bacteria in 28 hospitalized cases with lower respiratory tract infected by Stenotrophomonas maltophilia. Microbial sensitivity against strains of Stenotrophomonas maltophilia was studied by Kirby-Bauer methods. Results: Morbidity of the lower respiratory tract infection with Stenotrophomonas maltophilia increased. 82.14% of the patients were elder people, 46.43% of the patients were hospital acquired infection, 57.14% of cases were given glucocorticoid and all of the patients were given broad-spectrum antibiotics. Clinical manifestations were serious. Fatality rate of the patients was high (28.57%). Microbial sensitivity test in vitro showed that these strains were multiresistant to commonly used antibiotics especially imipenem. The sensitive rate of medicine was over 56.25% included levofloxacin, ticarcillin/clavulanate, ciprofloxacin, SMZco, piperacillin,ceftazidime, and mezlocillin. Conclusions: The clinical manifestations were serious. One of the reasons for high rate of morbidity and fatality was that those trains were resistant to commonly used antibiotics.

关 键 词：下呼吸道感染 嗜麦芽窄食单胞菌 病死率 患者 耐药 抗菌药物 治疗 难度 结论 目的 

分 类 号：R978[医药卫生—药品] R563[医药卫生—药学]