呼吸科病房嗜麦芽窄食单胞菌的分子流行病学调查  

Study on molecular epidemiology of Stenotrophomonas maltophilia in respiratory ward

作　　者：金光耀[1] 卓超[1] 邱桂霞[1] 袁锦屏[1] 杨灵[1] 钟南山[1] 

机构地区：[1]呼吸疾病国家重点实验室(广州医学院)广州医学院第一附属医院呼吸科,510120

出　　处：《国际呼吸杂志》2009年第21期1310-1313,共4页International Journal of Respiration

基　　金：广州市科技局重点攻关项目（2006Z1-E0141）

摘　　要：目的了解广州呼吸疾病研究所嗜麦芽窄食单胞菌分子流行病学与临床危险因素的关系。方法回顾分析2008年3～4月呼吸科20株I临床分离嗜麦芽窄食单胞菌的药敏结果。ERIC—PCR分析菌株的来源特征。分析患者的临床危险因素包括基础疾病，抗生素治疗情况，机械通气史等。结果20株嗜麦芽窄食单胞菌体外对亚胺培南、头孢噻肟、头孢吡肟、头孢曲松、氨曲南等100％耐药；对环丙沙星、阿米卡星、复方磺胺甲嘌唑和米诺环素等的敏感性分别为65％、65％、85％和95％；ERIC—PCR显示20株嗜麦芽窄食单胞菌由17种不同克隆构成，药敏谱与基因型之间无显著相关性；患者临床资料显示其普遍具有易感性。结论20株嗜麦芽窄食单胞菌分子流行病学调查显示其基因型多态性，未发现克隆株的传播；在严格的感染控制措施下，嗜麦芽窄食单胞菌不易出现克隆传播，降低临床危险因素对控制嗜麦芽窄食单胞菌发生至关重要。Objective To investigate the epidemiological conditions of Stenotrophomonas maltophilia and their clinical risk factors in respiratory ward. Methods Antibiotic susceptibility data of Slmahophilia in respiratory ward and respiratorial ICU （RICU） from March to April 2008 was collected. Clinic isolates homology was analyzed by the method of ERIC-PCR. Retrospective analysis was made on the clinical risk factors including the underling diseases, the history of antibiotic treatment, the history of mechanical ventilation and ect. Results All Stenotrophomonas mahophilia strains showed resistance to imipenem, cefotaxime, cefepime, ceftriaxone, aztreonam; the resistance to Ciprofloxacin, amikacin, compound sulfamethoxazole, minocycline was 65 %, 65 %, 85 %, 95 % ; strains could be divided into 17 different clones by the method of ERIC-PCR,there was no correlation between susceptibility spectrum and genotype;the clinical data of patients showed they all had risk factors. Conclusions This survey revealed that there was a genotype polymorphism among all 20 strains of Stenotrophomonas maltophilia. Reducing the clinical risk factors was crucial for the control of Stenotrophomonas mahophilia.

关 键 词：嗜麦芽窄食单胞菌 ERIC-PCR 分子流行病学 

分 类 号：R446.5[医药卫生—诊断学]