2012年中国CHINET嗜麦芽窄食单胞菌耐药性监测  

CHINET 2012 antimicrobial rsistance surveillance in Stenotrophomonas maltophilia across China

作　　者：艾效曼[1] 胡云建[1] 胡志东[2] 李全[2] 孙自镛[3] 陈中举[3] 徐英春[4] 张小江[4] 汪复[5] 朱德妹[5] 胡付品[5] 倪语星[6] 孙景勇[6] 卓超[7] 苏丹虹[7] 徐元宏[8] 沈继录[8] 俞云松[9] 林洁[9] 单斌[10] 杜艳[10] 张朝霞[11] 季萍[11] 褚云卓[12] 魏莲花[13] 吴玲[13] 王传清[14] 王爱敏[14] 张泓[15] 孔菁[15] 

机构地区：[1]北京医院检验科,北京100730 [2]天津医科大学总医院 [3]华中科技大学同济医学院附属同济医院 [4]中国医学科学院中国协和医科大学北京协和医院 [5]复旦大学附属华山医院 [6]上海交通大学医学院附属瑞金医院 [7]广州医科大学附属第一医院 [8]安徽医科大学第一附属医院 [9]浙江大学医学院附属邵逸夫医院 [10]昆明医科大学第一附属医院 [11]新疆医科大学第一附属医院 [12]中国医科大学附属第一医院 [13]甘肃省人民医院 [14]复旦大学附属儿科医院 [15]上海交通大学附属上海儿童医院

出　　处：《中国感染与化疗杂志》2014年第6期488-492,共5页Chinese Journal of Infection and Chemotherapy

摘　　要：目的了解国内不同地区15所医院2012年临床分离嗜麦芽窄食单胞菌对抗菌药物的耐药性。方法对国内主要地区15所医院2012年收集的临床非重复嗜麦芽窄食单胞菌菌株,按统一方案及材料、采用纸片扩散法或自动化仪器法进行细菌药敏试验,按照CLSI 2012年标准判读结果。结果全年共收集2 156株嗜麦芽窄食单胞菌。其中住院患者分离2 103株,占97.5%;门诊患者分离53株,占2.5%。60岁及以上的老年患者分离1 410株,占65.4%,小于18岁的患者分离115株,占5.3%。分离自痰液等呼吸道分泌物标本1 770株,占82.1%;分离自血液、胸腹水、关节腔液、脑脊液等无菌体液标本81株,占3.8%。该菌对甲氧苄啶-磺胺甲口恶唑、左氧氟沙星和米诺环素的耐药率分别为10.0%、10.5%和3.8%,对头孢哌酮-舒巴坦的耐药率为24.4%。结论嗜麦芽窄食单胞菌主要分离于住院患者及其痰液等呼吸道标本,且多见于60岁及以上的老年患者。该菌对大多数常用抗菌药物固有耐药,但对CLSI推荐的甲氧苄啶-磺胺甲口恶唑、左氧氟沙星和米诺环素的耐药率低。头孢哌酮-舒巴坦对该菌亦有较好抗菌活性。临床应以药敏试验结果合理选用治疗嗜麦芽窄食单胞菌的抗菌药物。Objective To investigate the antimicrobial resistance of clinical Stenotrophomonas maltophilia isolates from 15 hospitals in several regions of China during 2012 . Methods Fifteen representative general hospitals were involved in this program .Bacterial susceptibility testing was carried out by means of a unified protocol using Kirby‐Bauer method and minimum inhibitory concentration （ MIC ） determination .The results were analyzed according to the 2012 CLSI breakpoints .Results Most （97 .5% ） of the 2 156 clinical strains of S . maltophilia were isolated from inpatients .Only 2 .5% of the isolates were from outpatients .About 65 .4% （1410/2156） of the strains were isolated from old patients at least 60 years of age ,and only 5 .3% （115/2156） were from patients of 18 years old or younger .Sputum and respiratory tract secretion were the most common specimen source , accounting for 82 .1% .And 3 .8% of the isolates were from blood ,abdominal fluid and other sterile body fluids .About 10 .0% ,10 .5 % ,3 .8 % and 24 .4% of the S . maltophilia strains were resistant to trimethoprim‐sulfamethoxazole , levofloxacin , minocycline , and cefoperazone‐sulbactam , respectively . Conclusions Majority of S . maltophilia strains are isolated from respiratory tract specimens of inpatients .Such strains are usually isolated from old patients at lease 60 years of age .The S . maltophilia strains are intrinsically resistant to most antibacterial agents , but still show low resistance to trimethoprim‐sulfamethoxazole ,levofloxacin and minocycline .Antimicrobial therapy for S .maltophiliastrains should be based on the results of antimicrobial susceptibility testing .

关 键 词：嗜麦芽窄食单胞菌 不发酵糖革兰阴性杆菌 抗菌药物 药敏试验 

分 类 号：R446.5[医药卫生—诊断学]