肿瘤专科医院嗜麦芽寡养单胞菌感染的临床分布及药敏趋势分析  

Clinical distribution of Stenotrophomonas maltophilia causing infection in a tumor hospital and analysis of trend of drug susceptibility

作　　者：赵擎宇[1,2] 潘纩 沈珏[1] 黄一浓 吴春燕[3] 

机构地区：[1]中山大学肿瘤防治中心院感科,广东广州510060 [2]中山大学肿瘤防治中心院重症医学科,广东广州510060 [3]中山大学肿瘤防治中心院中山医学院,广东广州510060

出　　处：《中华医院感染学杂志》2014年第21期5224-5226,共3页Chinese Journal of Nosocomiology

基　　金：国家卫生部专项基金资助项目(卫规财2009-172)

摘　　要：目的了解嗜麦芽寡养单胞菌(SMA)感染的临床特点及耐药性。方法回顾性分析肿瘤中心2006年1月-2012年12月临床分离的SMA分布及耐药性,采用法国生物梅里埃公司VITEK-32全自动微生物分析仪进行细菌鉴定及药敏试验。结果共分离出147株SMA,其中127株属于感染菌株占86.4%,20株属于定植菌株占13.6%,SMA感染菌株对头孢他啶、哌拉西林/他唑巴坦、左氧氟沙星和头孢哌酮/舒巴坦的敏感率分别为50.4%、64.6%、61.4%、70.1%,定植菌株分别为55.0%、65.0%、65.0%、70.0%;标本来源以痰液最多占78.2%,其次为胸、腹腔积液占8.2%;科室分布主要为重症医学科占59.2%和肿瘤内科占11.6%。结论 SMA是医院感染中重要致病菌之一,主要引起呼吸道疾病;虽然对常用抗菌药物仍有相当的敏感性,但其耐药性日趋严重,临床对具易感因素的肿瘤患者应尽早采取有效预防控制措施,疑似SMA感染时应注意合理使用抗菌药物。OBJECTIVE To understand the clinical characteristics of Stenotrophomonas maltophilia infection and analyze the drug resistance .METHODS The distribution and drug resistance of the clinical isolates of S .malto-philia that were isolated from the cancer center from Jan 2006 to Dec 2012 were retrospectively analyzed ,then the strains were identified by using VITEK-32 automatic microorganism analyzer of BioMerieux ,France ,and the drug susceptibility testing was performed .RESULTS A total of 147 strains of S .maltophilia have been isolated ,inclu-ding 127 （86 .4% ） strains of S .maltophilia causing infections and 20 （13 .6% ） colonized strains .The drug sus-ceptibility rates of the S .maltophilia strains causing infections to ceftazidime ,piperacillin-tazobactam ,levofloxa-cin ,and cefoperazone-sulbactam were 50 .4% ,64 .6% ,61 .4% ,and 70 .1% ,respectively ,while the drug suscep-tibility rates of the colonized strains were 55 .0% ,65 .0% ,65 .0% ,and 70 .0% ,respectively .The sputum （78 .2% ） was the predominant specimens source , followed by the pleural and peritoneal effusions （8 .2% ） . 59 .2% of the strains were isolated from the critical care medicine department ,and 11 .6% were isolated from the oncology department .CONCLUSION The S .maltophilia is one of major species of pathogens causing nosocomial infection and mainly causes respiratory disease .Although the S .maltophilia remains highly susceptible to the commonly used antibiotics ,the drug resistance is increasingly serious .It is necessary to take effective prevention measures for the tumor patients at high risk of the S .maltophilia infection and reasonably use antibiotics for the patients with suspected S .maltophilia infection .

关 键 词：嗜麦芽寡养单胞菌 肿瘤患者 易感因素 抗菌药物 药敏率 

分 类 号：R378[医药卫生—病原生物学]