木糖氧化产碱菌医院感染调查分析  

Nosocomial Alcaligenes xylosoxidans Infection

作　　者：何岱昆[1] 申捷[1] 李刚[1] 李宏治[1] 

机构地区：[1]复旦大学附属金山医院化学应急救治中心ICU,上海200540

出　　处：《中华医院感染学杂志》2008年第9期1273-1275,共3页Chinese Journal of Nosocomiology

摘　　要：目的调查木糖氧化产碱菌医院感染分布及耐药特点,以探讨发生原因与防治措施。方法对医院2004年9月-2006年8月临床标本中分离的1323株木糖氧化产碱菌进行回顾性分析。结果木糖氧化产碱菌主要出现于痰标本中,占99.85%,偶尔出现在伤口分泌物和粪标本中;木糖氧化产碱菌感染尤以呼吸科和重症监护病房(ICU)分布为多,分别占46.94%和12.77%,其次是心内科、内分泌科和血液科病房;该菌对氨基糖苷类(阿米卡星、庆大霉素)、喹诺酮类(环丙沙星)、氨曲南、头孢吡肟等耐药现象严重,耐药率>98.00%;而其对碳青酶烯类药物、含酶抑制剂复合制剂及三代头孢(头孢哌酮、头孢他啶)等抗菌药物敏感,耐药率<5.00%。结论加强医院环境管理和器械消毒,合理使用抗菌药物,控制木糖氧化产碱菌在医院内的定植与播散。OBJECTIVE To investigate the clinical distribution and resistance of Alcaligenes xylosoxidans, discussing risk factors of nosocomial infection and measures of prevention and treatment. METHODS We retrospectively analyzed 1323 isolated strains of Al. xylosoxidans in our hospital from Sep 2004 to Aug 2006. RESULTS For specimen from which Al. xylosoxidans was examined, sputum accounted for 99.85%, being the highest percentage. Al. xylosoxidans was especially distributed at respiratory ward （46.94%） and intensive care unit （ICU） ward （12. 77%）. Then was cardiovascular ward, endocrinology ward and hematology ward. The antibiotic drugs which had the high drug-resistance rate （i. e. more than 98%） were aminoglycoside （amikacin and gentamicin）, quinolone （ciprofloxacin） and cefepime. But the drug-resistance rate to carbapenems, ^-lactam/O- lactamase inhibitor combinations and the third generation cepholosporins（cefoperazone and ceftazidime） was less than 5%. CONCLUSIONS It is important for clinic to strengthen the disinfection for hospital environment and to use antibiotic drugs reasonably in order to control colonization and spread of Al. xylosoxidans in hospital.

关 键 词：木糖氧化产碱菌 医院感染 危险因素 防治措施 

分 类 号：R181.32[医药卫生—流行病学]