洋葱伯克霍尔德菌感染的临床监测及耐药性变异  

Clinical surveillance of burkholdeiia cepacia infection and its variation of drug resistance

作　　者：车惠琴[1] 从宏亮[1] 朱光明[1] 

机构地区：[1]湖州市第一人民医院检验科,浙江湖州313000

出　　处：《中华医院感染学杂志》2011年第2期379-381,共3页Chinese Journal of Nosocomiology

摘　　要：目的监测医院洋葱伯克霍尔德菌感染的临床分布特征及耐药性的变异。方法对2004年1月-2008年12月临床分离的122株洋葱伯克霍尔德菌感染患者的资料作回顾性分析。结果洋葱伯克霍尔德菌的分离率逐年增加,从2004年0.28%上升至2008年的0.44%,主要来源为呼吸道标本占68.8%;以重症监护病房菌株分离率最高占58.2%;所有感染患者均有严重的基础疾病,其中严重创伤患者占32.8%;有15种抗菌药物对该菌的耐药率>50.0%,耐药率<50.0%的为头孢他啶(25.0%～48.6%)、美罗培南(42.9%～45.9%)、环丙沙星(20.0%～37.8%)、左氧氟沙星(27.8%～40.5%)、磺胺甲噁唑/甲氧苄啶(18.9%～29.2%)、米诺环素(0～2.7%)。结论洋葱伯克霍尔德菌在临床中的分离率有增加趋势,该菌耐药谱广,临床抗感染治疗应结合体外抗菌药物敏感试验结果。OBJECTIVE To monitor the characteristics of clinical distribution and the variation of drug resistance of Burkholdeiia cepacia.METHODS Retrospective analysis of the data of 122 strains of B.cepacia isolated from the patients from Jan 2004 to Dec 2008 was performed.RESULTS The isolation rate of Burkholderia cepacia was increased from 0.28% in 2004 to 0.44% in 2008 and the isolated strains were mainly from respiratory tract samples,accouting for 68.8%.The isolation rate of pathogenic bacteria in ICU was the highest with 58.2%;All the infected patents had the experiences of suffering from severe primary diseases,with 32.8% from severe trauma patients.The drug resistance rates of this bacteria to 15 kinds of antibiotics were more than 50.0% and only six of them were less than 50.0%,including ceftazidime with 25.0%～48.6%,meropenem 42.9～45.9%,ciprofloxacin 20.0%～37.8%,levofoxacin 27.8%～40.5%,sulfamethoxazole/trimethoprim 18.9%～29.2%,and minocycline 0～2.7%.CONCLUSION Clinical isolating rate of B.cepacia keeps an upward tendency and the drug resistant spectrum of this bacteria is extended.The clinical anti-infection treatment should be performed based on the antibiotic sensitivity test.

关 键 词：洋葱伯克霍尔德菌 临床监测 耐药性 变异 

分 类 号：R378[医药卫生—病原生物学]