1999～2003年嗜麦芽窄食单胞菌的分离情况及耐药趋势分析  

The Analysis of the Isolation Of Strenotrophomonas maltophilia and Its Resistance Tendency to Antimicrobial Agents from 1999 to 2003

作　　者：费鲜明[1] 吕火祥[1] 胡庆丰[1] 沈蓓琼[1] 刘建栋[1] 

机构地区：[1]浙江省人民医院检验医学中心,浙江杭州310014

出　　处：《中国实验诊断学》2005年第3期347-350,共4页Chinese Journal of Laboratory Diagnosis

摘　　要：目的了解从1999年到2003年嗜麦芽窄食单胞菌在临床标本中的分离情况及其耐药趋势,为临床感染的预防和治疗提供参考资料.方法回顾分析1999～2003年间所有标本中嗜麦芽窄食单胞菌的分离率,在标本和病区的分布构成情况以及对21种抗菌药物的耐药率.结果嗜麦芽窄食单胞菌的分离率有逐年升高的趋势,从1999年的0.29%增至2003年的1.67%;其在呼吸道标本(痰液+咽拭子)的分离率最高(63.27%),其次是尿液(19.39%),血液(12.65%);病区分布以重症监护室最高(13.88%),其次是普外科(12.86%),所有内科病区(不含ICU)占56.94%;嗜麦芽窄食单胞菌对13种抗菌药的耐药率大于50%,仅对其中8种的耐药率每年均低于50%,但也呈逐年递增的趋势,分别为:哌拉西林/他唑巴坦4.35%～48.98%,头孢他啶4.08%～47.75%,头孢吡肟3.00%～24.49%,头孢替坦6.00%～28.57%,替卡西林13.33%～36.73%,左氟沙星25.76%～49.00%,环丙沙星10.61%～43.67%,复方新诺明20.00%～42.42%.结论嗜麦芽窄食单胞菌的临床分离率在增加,其对多数抗菌药物有较高的耐药性,即使对相对敏感的药物也呈逐年增高的趋势,所以感染的治疗应当依据抗菌药物的体外敏感试验.Objective To study the isolation and resistance tendency of Strenotrophomonas maltophilia to antimicrobial agents from 1999 to 2003 to provide valuable data for infection prevention and therapy. Methods We reviewed the isolation rates, distribution in clinical specimens and wards, and the resistance rates of Strenotrophomonas maltophilia to 21 kinds of antimicrobial agents from 1999 to 2003. Results There was an increasing tendency of isolation rates of Strenotrophomonas maltophilia every year, which was 0.29% in 1999 but 1.67% in 2003. In the five years, there was a highest isolation rate of 63.27% in specimens from respiratory tract, the next was the urine(19.39%) and blood(12.65%). Concerning the wards distribution, ICU had a highest rate of 13.88%, the next was general surgery department(12.86%). And all the inner medicine departments(excluding ICU) had an isolation rate of 56.94%. Strenotrophomonas maltophilai had resistance rates more than 50% to 13 kinds of antimicrobial agents, and it just had less 50% resistance rate only to 8 kinds, which were piperacillin/tazobactam 4.34%～48.98%, ceftazidime 4.08%～47.75%, cefepime 3.00%～24.49%, cefotetan 6.00%～28.57%, ticarcillin 13.33%～36.73%, levofloxacin 25.76%～49.00%, ciprofloxacin 10.61%～43.67% and Sulfamethoxazole/Trimethoprim 20.00%～42.42%, while there still is an increasing resistance tendency to them. Conclusion The clinical isolation rate of Strenotrophomonas maltophilia is increasing, and has higher resistance rates to many antimicrobial agents as well as an increasing resistance tendency to relatively susceptive antimicrobial agents every year. So physicians should prescribe on the basis of antimicrobial agents susceptibility tests in vitro.

关 键 词：嗜麦芽窄食单胞菌 分离率 分布情况 耐药性分析 

分 类 号：R446.5[医药卫生—诊断学]