嗜麦芽窄食单胞菌感染的临床治疗及耐药性研究  

Predisposing Factors and Antimicrobial Resistance of S.Maltophilia CHEN

作　　者：陈霏[1] 李维欣[1] 蒋毋右[1] 

机构地区：[1]上海市普陀区人民医院呼吸内科,上海200060

出　　处：《医学临床研究》2007年第11期1867-1869,共3页Journal of Clinical Research

摘　　要：【目的】了解嗜麦芽窄食单胞菌易感因素、临床分布、耐药情况及抗感染治疗的效果。【方法】对29例嗜麦芽窄食单胞菌感染患者的临床资料和细菌培养结果进行回顾性分析。【结果】29例患者中28例为医院内感染,多数为呼吸道感染,93.1%(27/29)的患者患有基础疾病,其中慢性阻塞性肺疾病(COPD)合并呼吸衰竭最常见。96.5%(28/29)的患者曾使用过广谱抗生素,41.4%(12/29)曾接受侵入性检查和治疗。药敏试验表明该菌高度耐药,仅复方新诺明有较高的敏感率(75%),临床经验治疗多数效果不佳。【结论】嗜麦芽窄食单胞菌已成为医院感染尤其是呼吸道感染的重要致病菌之一,常发生于住院周期长、免疫功能低下、有慢性基础疾病、接受激素及长期广谱抗菌药物治疗的老年病人。嗜麦芽窄食单胞菌对多种抗生素耐药,治疗颇为困难,临床经验用药可首先考虑加酶抑制剂(克拉维酸)抗生素与复方新诺明联用。[Objective]To know the predisposing factors and antimicrobial resistance of S. Maltophilia, and also to know the effect of treatment. [Methods]The clinical data and drug susceptibility results of 29 cases infected with S. maltophilia were analyzed retrospectively. [Results] Twenty eight subjects were nosocomial infection, most of which were respiratory infections. 93.1% of the cases had underlying diseases, and most of which were chronic obstructive pulmonary disease complicated with respiratory failure. 96.5 % patients used broad spectrum antibiotics previously and 41, 4% accepted invasive examination or treatment. Drug susceptibility results showed that these strains were multi-resistant to common antibiotics, and only trimethoprim-sulfamethoxazole had the sensitive rate over 75%. Empirical antibiotic treatment often had no effect. [Conclusion] S. Maltophilia has become one of the germs in respiratory tract infection in the hospital. The high risk factors of this infection include elder, underlying disease, accepted hormone or antibiotics for long term. S. Maltophilia is multi-drug resistant. It is difficult to treat the infection caused by S. Maltophilia. β-lactam/β-lactamase inhibitor combined with trimethoprim-sulfamethoxazole could be the first choice of empirical treatment.

关 键 词：假单胞菌感染 药物耐受性 

分 类 号：R378.99[医药卫生—病原生物学]