嗜麦芽寡氧单胞菌下呼吸道医院感染耐药现状  

Current status of risk factors and durg-resistance of hospital acquired lower respiratoty infection by stenotrophomonas maltophilia

作　　者：周超[1] 潘晓龙[2] 胡斌[1] 彭卫东[1] 

机构地区：[1]安徽省铜陵市人民医院呼吸内科 [2]安徽省铜陵市人民医院细菌室,244000

出　　处：《临床肺科杂志》2005年第5期574-575,共2页Journal of Clinical Pulmonary Medicine

摘　　要：目的观察嗜麦芽寡氧单胞菌下呼吸道医院感染的危险因素并分析其体外耐药特征。方法对36例嗜麦芽寡氧单胞菌下呼吸道医院感染的危险因素进行分析。采用纸片法测定该菌的体外药物敏感性。结果在36例感染病例中,全部患者在感染前均应用过广谱抗菌药物,94%患有各种严重基础疾患,67%的患者接受过超过3天的糖皮质激素治疗,56%接受过有创机械通气。体外药敏提示该菌多种耐药明显,敏感率大于60%,仅有头孢他定、环丙沙星、TMP-SMZ。结论嗜麦芽寡氧单胞菌下呼吸道医院感染临床缺乏特征性,由于该菌耐药现象严重,临床抗感染治疗困难。Objective To review the risk factors of lower respiratory tract infection caused by stenotrophomonas maltophilia and to analyze antimicrobial characteristics of stenotrophomonas maltophilia strains.Methods A retrospective study (n=36) of the risk factors related lower respiratory tract infection by stenotrophomonas maltophilia was made. Drug sensitivity against stenotrophomonas maltophilia was studied by Kirby-Bauer method.Results All of the cases had used broad-spectrum antimicrobial agents before the infection. 94% of the cases had serious underlying diseases and endocrines were used in 67%. 56% of the cases were experienced hurtful ventilator. Drug sensitivity tests in vitro showed that these strains were multi-resistant to commonly used antibiotics and the drugs with sensitive rate over 60% included cefaxidine, ciprofloxacin and TMP-SMZ.Conclusion The hospital-acquired lower respiratory infection by stenotrophomonas maltophilia develop at patients with various underlying diseases. Risk factors of morbidity were patients in ICU, acceptance of invasive treatment and inappropriate use of broad-spectrum antibiotics. There data indicate that stenotrophomonas maltophilia was multidrug-resistant.

关 键 词：下呼吸道医院感染 麦芽寡氧单胞菌 耐药现状 体外药物敏感性 糖皮质激素治疗 广谱抗菌药物 有创机械通气 危险因素 临床抗感染 耐药特征 感染病例 多种耐药 体外药敏 头孢他定 环丙沙星 耐药现象 治疗困难 纸片法 敏感率 

分 类 号：R446.5[医药卫生—诊断学]