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作 者:付祖姣[1] 李敏[1] 李子博[1] 杨芳慧[1] 周江[1] 周琳[1] 张成[1] 唐荣[1]
机构地区:[1]湖南省长沙医学院,长沙410219
出 处:《按摩与康复医学》2012年第32期2-3,共2页Chinese Manipulation and Rehabilitation Medicine
基 金:项目资助;省教育厅项目(11c0137).
摘 要:目的:了解临床分离的嗜麦芽窄食单胞菌(Stenotrophomonas maltophilia,简称sMA)的临床分布及其耐药性,为临床合理用药提供依据。方法:收集2010年7月至2011年4月湖南省妇幼保健院门诊和住院患者送检标本,进行细菌培养,挑取革兰氏阴性细菌进行氧化酶试验,对氧化醇阴性细菌进行菌种鉴定和耐药性分析。结果:本研究分离到78株SMA茸株,其中,痰标本的分离率最高(35.89%),其次为脓液(17.95%)、宫颈分泌物(15.38%)、创面分泌物(12.82%)、咽拭子(10.26%)、血液(3.85%)、尿液(3.85%)。药敏结果显示,SMA菌株对很多抗菌药物具有不同程度的耐药性,其耐药率分别为:米诺环素(6.41%)、左氧氟沙星(8.97%)、复方新诺明(11.54%)、头孢他啶(24.36%)、环丙沙星(28.21%)、头孢哌酮(38.46%)、替卡西林/克拉维酸为(43.56%)、亚胺培南(100%)。结论:临床分离并鉴定的SMA菌株,以痰标本为主。这些菌株对亚胺培南具有天然耐药性,但对米诺环素、左氧氟沙星、复方新诺明的耐药率较低。建议临床在治疗sMA感染时,尽量选用SMA敏感的药物,并合理使用。Objective:To provide the basis for the suitable clinic antibiotic management,the clinical distribution and drug resistance of Stenotroph- omonas mahophilia (SMA) was studied. Methods: Samples from outpatients and inpatlents of Maternal and Child Health Hospital of Hunan Province from July 2010 to April 2011 were collected and cultured. Then the G--strains were detected by oxidase test. The oxidase--negative strains were i- dentified,and the drug resistance tests of these strains were carried. Result:78 SMA strains were isolated from different samples. Among them, spu- tum samples has the highest isolation rate (35.89 %), then fester, cervical secretion, wound secretion, throat swab, blood, urine. Drug resistance tests shows SMA strains are resistance to many anti--bacterial drugs. The levels are: minocycline (6. 41%), levofloxaein (8. 97%), TMP/SMZ (11.54%) ,ceftazidime (24.36%) ,ciprofloxacin (28.21%) ,cefopera%one (38.46%) ,ticarcillin-- clavulanate (43.56%) ,imipenem (100%). Conclusion:SMA strains isolated from clinical samples mainly come from sputum specimens. These strains show a natural resistance to imipenem,but show low resistance to minocycline, levofloxacin,TMP/SMZ. It suggest the doctor to try to choose SMA highly susceptible drugs to treat the infection by SMA in clinical,and use them suitably.
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