我院脑膜败血伊丽莎白菌的临床分布、产酶情况及耐药性分析  

Analysis of Clinical Distribution,Enzyme Production and Drug Resistance of Elizabethkingia meningospetica in Our Hospital

作　　者：林美丽[1] 吴俊琪[1] 黄俊伟[1] 应华永[1] 

机构地区：[1]金华市中心医院检验科,浙江金华321000

出　　处：《中国药房》2016年第14期1926-1929,共4页China Pharmacy

摘　　要：目的:探讨我院脑膜败血伊丽莎白菌的临床分布、产酶情况及耐药特征,为临床治疗和预防感染提供参考。方法:回顾性分析我院2011-2015年脑膜败血伊丽莎白菌致医院感染患者的临床资料,采用全自动细菌鉴定仪进行细菌鉴定,采用纸片扩散(K-B)法进行药敏试验,采用K-B法、双纸片增效法、改良三维试验法进行超广谱β-内酰胺酶(ESBLs)、头孢菌素酶(AmpC)、金属β-内酰胺酶(MBL)的表型确证。结果:共检出脑膜败血伊丽莎白菌76株,主要来源于痰液标本(75.0%),其患者主要来自于重症医学科(57.9%);76株脑膜败血伊丽莎白菌对亚胺培南、美罗培南、多黏菌素B、妥布霉素、庆大霉素、阿米卡星、头孢吡肟等7种抗菌药物的耐药率为100%,对利福平、复方磺胺甲噁唑等及3种含酶抑制剂的耐药率均<30%,对万古霉素、米诺环素的耐药率为0;58株细菌产ESBLs(76.3%),47株细菌产MBL(61.8%),未检出细菌产AmpC。结论:脑膜败血伊丽莎白菌可导致免疫力低下患者发生医院感染;该菌具有较高的耐药水平,可能与ESBLs、MBL高检出率有关;万古霉素与米诺环素是治疗该菌感染的首选药物。OBJECTIVE：To discuss the clinical distribution,enzyme production and drug resistance of Elizabethkingia meningospetica in our hospital,and to provide evidence for clinical treatment and infection prevention. METHODS：Clinical information of the patients with hospital infection caused by E. meningospetica were analyzed retrospectively during 2011-2015. Automatic bacterial identification apparatus and K-B assay were used for bacterial identification and drug sensitivity test. Phenotype of ESBLs,AmpC and MBL were determined by K-B assay,double-disc synergy method and modified three-dimensional test. RESULTS：76strains of E. meningospetica were isolated,mainly from sputum sample（75.0%）;the patients mainly came from the intensive care unit（57.9%）. 76 strains of E. meningospetica were completely resistant to 7 antibiotics as imipenem,meropenem PMB to bramycin,gentamicin,amikacin and cefepime;resistant rate to rifampin,SMZ and 3 kinds of enzyme inhibitors were all lower than30%;resistant rate to vancomycin and minocycline were equal to 0.58 strain of ESBLs-producing bacterial（76.3%）and 47 strains of MBL-producing bacterial（61.8%）were detected,and no Amp C-producing bacterial was found. CONCLUSIONS：E. meningospetica will cause hospital infection in low immunity patients;the bacterial is highly resistant to antibiotics,which is correlated to high detection rate of ESBLs and MBL. Vancomycin and minocycline are first choice for E. meningospetica therapy.

关 键 词：脑膜败血伊丽莎白菌 医院感染 临床分布 产超广谱Β-内酰胺酶 头孢菌素酶 金属Β-内酰胺酶 耐药性 

分 类 号：R378[医药卫生—病原生物学]