1212株嗜麦芽窄食单胞菌的临床分布及耐药性分析  

Analysis of clinical distribution and drug resistance of 1212 strains of Stenotrophomonas maltophilia

作　　者：王亚华[1] 祝永明[2] 吴晓燕[3] 王蔚[4] 邵平扬[4] WANG Yahua ZHU Yongming WU Xiaoyan WANG Wei SHAO Pingyang(Department of Pharmacy, First Hospital of Jiaxing, Zhejiang Province, Jiaxing 314001, China Department of Pharmacy, Second Hospital of Jiaxing, Zhejiang Province, Jiaxing 315000, China Department of Laboratory, Second Hospital of Jiaxing, Zhejiang Province, Jiaxing 314000, China Department of Laboratory, First Hospital of Jiaxing, Zhejiang Province, Jiaxing 314001, China)

机构地区：[1]浙江省嘉兴市第一医院药剂科,浙江嘉兴314001 [2]浙江省嘉兴市第二医院药剂科,浙江嘉兴314000 [3]浙江省嘉兴市第二医院检验科,浙江嘉兴314000 [4]浙江省嘉兴市第一医院检验科,浙江嘉兴314001

出　　处：《中国医药导报》2017年第13期124-127,共4页China Medical Herald

基　　金：浙江省重点科技创新团队建设项目(2010R50019)

摘　　要：目的调查分析嗜麦芽窄食单胞菌的耐药性,为临床合理使用抗菌药物和及早预防与控制医院感染提供科学依据。方法回顾性统计2014年1月~2016年12月嘉兴地区两所综合性三甲医院中分离的嗜麦芽窄食单胞菌的临床资料,进行耐药性分析。结果 2014年1月~2016年12月共分离到嗜麦芽窄食单胞菌1212株。标本来源前5位为下呼道标本、创面分泌物、尿液、腹腔引流液和胆汁,分别占86.30%、4.04%、3.14%、2.56%、2.15%。菌株主要分布于ICU、呼吸内科、神经外科、急诊医学科和肝胆外科,检出率分别为29.29%、12.79%、10.56%、8.00%、7.34%。3年间嗜麦芽窄食单胞菌对米诺环素、复方磺胺甲噁唑、左氧氟沙星敏感,耐药率低于15%;而对头孢哌酮/舒巴坦、头孢他啶耐药性较高,且呈逐年上升趋势。结论嗜麦芽窄食单胞菌主要来源于呼吸道标本,该菌对多种抗菌物固有耐药,但对CLSI推荐的米诺环素、复方磺胺甲恶唑、左氧氟沙星的耐药率低,头孢他定对该菌耐药性高。临床应以药敏试验结果合理选用治疗嗜麦芽窄食单胞菌感染的抗菌药物。Objective To investigate the drug resistance of Stenotrophomonas maltophilia, to provide scientific basis for rational use of antibiotics and Stenotrophomonas maltophilia hospital infection prevention/control at an early stage. Methods The clinical data of Stenotrophomonas maltophilia infection from two Grade A Class 3 Hospitals in Jiaxing, from January 2014 to December 2016, was collected retrospectively, and the collected, and the drug resistance of Stenotrophomonas maltophilia was analyzed. Results A total of 1212 strains of Stenotrophomonas maltophilia were de- tached from January 2014 to December 2016 in this study. The first 5 specimens was lower respiratory tract, wound se- cretion, the urine, the peritoneal drainage fluid and the bile, respectively, and the proportion were 86.30%, 4.04%, 3.14%, 2.56%, 2.15%. The strains were mainly distributed in ICU, pneumology department, neurosurgery department, e- mergency department and department of hepatobiliary surgery, the detection rates were 29.29%, 12.79%, 10.56%, 8.00%, 7.34%. Stenotrophomonas ma!tophilia was sensitive to minocycline, compound sulfamethoxazole and levofloxacin, and the drug resistance rate was less than 15% in the 3 years. While the drug resistance to Cefoperazone/Sulbactam and Ceftazidime wis high, with the upward trend. Conclusion Stenotrophomonas maltophilia mainly roots from respiratory tract. It is a muhi-drug inherent resistant bacterium. While it is sensitive to minocycline, compound sulfamethoxazole, levofloxacin which are recommended by CLSI. During Stenotrophomonas maltophilia infection, antibiotics choice shoudbe based on antimicrobial susceptibility test in clinic.

关 键 词：嗜麦芽窄食单胞菌 临床分布 抗菌药物 耐药性 

分 类 号：R446.5[医药卫生—诊断学]