皮氏罗尔斯顿菌医院感染的临床分析  

Clinical analysis of nosocomial infections caused by Ralstonia pickettii

作　　者：闫涛[1] 楼正青[1] 王丽春[2] 王文龙[3] 

机构地区：[1]杭州市中医院检验科,浙江杭州310007 [2]杭州市中医院院感科,浙江杭州310007 [3]杭州市中医院ICU,浙江杭州310007

出　　处：《中华医院感染学杂志》2014年第17期4182-4184,共3页Chinese Journal of Nosocomiology

基　　金：浙江省卫生厅基金资助项目(2013KYA158)

摘　　要：目的探讨皮氏罗尔斯顿菌所致医院感染的临床易感因素、防治措施及对抗菌药物的耐药性,为临床防治提供依据。方法对医院20株皮氏罗尔斯顿菌所致医院感染进行回顾性调查分析;采用法国生物梅里埃公司VITEK-2全自动微生物鉴定仪进行菌株鉴定,采用K-B法进行药敏试验,结果判断参照美国临床实验室标准化研究所标准;采用WHONET软件进行统计分析。结果皮氏罗尔斯顿菌所致医院感染与患者的年龄、伴有基础疾病、接受呼吸机治疗、使用大量广谱强效抗菌药物密切相关;皮氏罗尔斯顿菌对氨苄西林、头孢替坦、氨曲南、呋喃妥因耐药率达100.0%,对哌拉西林/他唑巴坦、左氧氟沙星、磺胺甲噁唑/甲氧苄啶、头孢哌酮/舒巴坦、头孢曲松、头孢吡肟、氨苄西林/舒巴坦、环丙沙星较敏感等,耐药率≤15.0%。结论对于皮氏罗尔斯顿菌所致医院感染,治疗上可考虑β-内酰胺酶类/β-内酰胺酶抑制剂、第三、四代头孢菌素、喹诺酮类、磺胺甲噁唑/甲氧苄啶等抗菌药物。OBJECTIVE To explore the risk factors for nosocomial infections caused by Ralstonia pickettii, put forward prevention measures, and analyze drug resistance so as to provide guidance for clinical treatment. METHODS The nosocomial infection induced by 20 strains of R. pickettii was retrospectively investigated, then the strains were identified by using VITEK-2 automatic microorganism identification system of BioMerieux, France; the drug susceptibility testing was performed with the use of K-B method, and the results were interpreted by referring to the criteria of Clinical Laboratory Standard Institute. RESULTS The nosocomial infection induced by R. pickettii was closely associated with the age, complication of underlying disease, mechanical ventilation, and use of highdose broad spectrum antibiotics. The drug resistance rates of the R. pickettii to ampicillin, cefotetan, aztreonam, and furadantin were 100.0% the drug resistance rates to piperacillin-tazobactam, levofloxacin, trimethoprim-sulfamethoxazole, cefoperazone-sulbactam, ceftriaxone, cefepime, ampicillin-sulbactam, and ciprofloxacin were less than 15.0%. CONCLUSION The β-1actamase or β-lactamase inhibitors, the third and fourth generations of cephalosporins, quinolones, and trimethoprim-sulfamethoxazole are effective in the treatment of the patients suffering from nosocomial infection caused by R. pickettii.

关 键 词：皮氏罗尔斯顿菌 医院感染 抗菌药物 

分 类 号：R378[医药卫生—病原生物学]