人苍白杆菌血流感染的临床研究  

Clinical study of bloodstream infections caused by Ochrobactrum anthropi

作　　者：圣朝军 徐雅萍[2] 张杜超[1] 刘超[1] 方向群[1] 

机构地区：[1]解放军总医院南楼呼吸科,北京100853 [2]解放军总医院南楼检验科,北京100853

出　　处：《中华医院感染学杂志》2015年第5期1017-1018,1036,共3页Chinese Journal of Nosocomiology

基　　金：军队保健专项基金资助项目(14BJZ0606)

摘　　要：目的探讨人苍白杆菌血流感染患者的特点,为临床诊疗提供参考。方法回顾性分析2011年1月-2013年12月医院6例患者送检血液标本鉴定为人苍白杆菌感染的临床资料,采用VITEK-2全自动细菌鉴定分析系统及其配套的革兰阴性杆菌鉴定卡进行细菌鉴定,采用纸片扩散法进行药敏试验。结果血液标本中共检出6株人苍白杆菌,其感染患者多有严重基础疾病、存在免疫功能低下;6例患者均出现发热及C-反应蛋白升高,4例患者白细胞升高占66.7%、5例出现中性粒细胞升高占83.3%;6株人苍白杆菌对青霉素类、头孢呋辛、头孢他啶等二、三代头孢菌素以及含酶抑制剂的复合抗菌药物几乎均耐药,对亚胺培南、美罗培南、环丙沙星、左氧氟沙星、阿米卡星、米诺环素、磺胺甲噁唑/甲氧苄啶敏感性较高;治愈或好转4例,放弃治疗或死亡2例。结论人苍白杆菌感染为机会性感染,病原菌的分离和鉴定是诊断本病的关键,治疗应依据菌株的药敏结果选择合理的抗菌药物。OBJECTIVE To explore the characteristics of the patients with bloodstream infections caused by Ochrobactrum anthropi so as to provide guidance for clinical diagnosis and treatment .METHODS The submitted blood specimens were collected from 6 patients with confirmed O . anthropi infections who were treated in the hospital from Jan 2011 to Dec 2013 ,then the clinical data were retrospectively analyzed ,the bacterial identification was conducted by means of VITEK‐2 automatic bacterial identification analysis system and supporting gram‐negative bacilli identification card , and the drug susceptibility testing was performed by using disk diffusion method .RESULTS Totally 6 strains of O .anthropi were isolated from the blood specimens ,most of the cases of infections were complicated with severe underlying diseases or low immune function .The fever and elevated level of C‐reactive protein emerged in all the 6 cases ,and there were 4 （66 .7% ） cases with elevated level of white blood cells and 5 （83 .3% ） cases with elevated level of neutrophils .Nearly all the 6 strains of O .anthropi were resistant to penicillins ,cefuroxime ,ceftazidime ,the second generation and third generation cephalosporins ,and enzyme in‐hibitor‐containing compound antibiotics ;the strains were highly susceptible to imipenem ,meropenem ,ciprofloxa‐cin ,levofloxacin ,amikacin ,minocycline ,and sulfamethoxazole‐trimethoprim .Totally 4 cases were cured or im‐proved ,and 2 cases abandoned the treatment or died .CONCLUSION The O .anthropi infection is the opportunistic infection ,it is crucial for the diagnosis of the disease to isolate and identify the pathogens ,and the antibiotics should be reasonably used on the basis of the results of drug susceptibility testing .

关 键 词：人苍白杆菌 血流感染 药物敏感试验 免疫功能低下 

分 类 号：R378[医药卫生—病原生物学]