类鼻疽伯克霍尔德菌感染的临床特点与耐药性分析  

Melioidosis Burkholderia infection in the clinical characteristicsand drug resistance analysis

作　　者：李天娇[1] 符惠群[1] 黄涛[1] 郭红荔[1] 

机构地区：[1]海南省人民医院,海南海口570311

出　　处：《中国实验诊断学》2011年第5期888-890,共3页Chinese Journal of Laboratory Diagnosis

摘　　要：目的了解我院类鼻疽病的临床特征,探讨早期诊断治疗及该菌的耐药性分析;统计近6年类鼻疽病病死率,并且了解实验室对该菌的细菌学鉴定和药敏试验方法。方法采用回顾性2003年4月~2010年4月期间收治的43例类鼻疽病感染者的临床症状以及治疗、愈后及半年后进行电话随访统计;结果患者起病时多以带有基础疾病时起病或是农作时外伤引起,临床症状多以畏寒、高热、肺部感染、败血症以及脏器损害和细菌毒素引起的全身反应为主要表现,病情较为严重,药敏结果类鼻疽伯霍尔德杆菌对亚胺培南敏感率达100%,对美洛培南、头孢哌酮/舒巴坦、哌拉西林/他唑巴坦敏感率达80%以上,对头孢他啶敏感率为66.7%,而对广谱青霉素类、氨基糖苷类耐药,对头孢类有不同程度的耐药。结论该病临床特征多样,首诊困难,误诊率高,广谱抗生素治疗无效,易延误病情,住院时间长,治疗成本高,应提高临床医生对此病的认识和警惕以尽快确诊。目前认为碳青霉烯类为首选抗生素,临床用药应为以碳青霉烯类为主的两种抗生素以上联合用药效果好。Objective To understand the clinical characters of Melioidosis in our hospital.and discuss its early diagnosis,treatment and drug resistance.;To count the Mortality of Melioidosis in recently six years and understand the Bacteriological identification and drug resistance test of Burkholderia mallei in our laboratory.Methods To Retrospectively analyzed the Clinical symptoms,treatment,heal and Telephone follow-up of 43 Burkholderia mallei patients during April 2003 to April 2010.Results The patients are often complicated by basic disease or caused by injure when farming.The clinical symptoms are often chills,high fever,lung infection,septicaemia,organ damage and bacterial toxin-induced systemic reaction.The patients＇ condition is severe,Imipenem-sensitive rate of 100%,80% of Burkholderia mallei is sensitive to meropenem,cefoperazone/ sulbactam,piperacillin/ tazobactam,and 66.7% of it is sensitive to ceftazidime,but it is resistant to penicillins,aminoglycosides and cephalosporins.Conclusion Clinical features of the disease is diversity.the first diagnosis of it is difficult.the rate of diagnosis is high.the disease is resistant to broad-spectrum antibiotic and is delayed easly,so the patients have to stay in hospital longer.The cost of treatment is high.physicians should improve the ability of diagnosis to the disease.Carbapenem is the first choice antibiotic.the treatment effect is good when carbapenem is associated with another kind of antibiotic.

关 键 词：类鼻疽伯霍尔德杆菌 临床特点 耐药性 

分 类 号：R446.5[医药卫生—诊断学]