脑膜败血伊丽莎白菌医院感染的特点与药敏分析  

Analysis of infection characteristics and drug susceptibility of Elizabethkingia meningoseptica nosocomial infection

作　　者：李文杰 林少华[1,2] 骆丰[1,2] 俞洪[3] 孙桂芹 LI Wen-jie;LIN Shao-hua;LUO feng;YU hong;SUN Gui-qin(The First Affiliated Hospital of Zhejiang Chinese Medical University,Hangzhou,Zhejiang 310018,China;不详)

机构地区：[1]浙江中医药大学附属第一医院检验科,浙江杭州310018 [2]浙江省中医院检验科,浙江杭州310018 [3]浙江中医药大学基础医学院 [4]浙江中医药大学医学技术学院,浙江杭州310053

出　　处：《中华医院感染学杂志》2020年第3期327-330,共4页Chinese Journal of Nosocomiology

基　　金：国家自然基金资助项目(31600644)。

摘　　要：目的探讨脑膜败血伊丽莎白菌(Elizabethkingia meningoseptica,EM)医院感染的临床特征及耐药性,为指导临床合理使用抗菌药物提供依据。方法回顾性分析2013年9月-2018年9月浙江省中医院下沙院区临床分离的36株EM,进行菌种鉴定及药敏试验,并统计分析该菌感染的特点及耐药性。结果36株EM主要来源于重症医学科(72.22%),其次是血液科(8.33%)和神经内科(5.56%);主要分离自呼吸道标本(痰液占83.33%),其他为血液、导管及腹水等。EM感染患者平均年龄为60岁,并伴有呼吸系统疾病、脑部疾病或肿瘤等。药敏结果显示,EM对呋喃妥因的耐药率达100%;对亚胺培南、头孢曲松等β-内酰胺类及丁胺卡那、妥布霉素等氨基糖苷类的耐药率均>97%;对左氧氟沙星、环丙沙星和哌拉西林/他唑巴坦敏感率>83%。结论EM感染患者主要为老年人,并伴有一定基础疾病,EM菌株对临床常用的β-内酰胺类和氨基糖苷类抗菌药物耐药率较高,临床治疗可考虑选择喹诺酮类和β-内酰胺酶抑制剂类抗菌药物。OBJECTIVE To explore the clinical characteristics and drug resistance of Elizabethkingia meningoseptica(EM)nosocomial infection,so as to provide evidence for guiding the rational use of antibiotics.METHODS A total of 36 isolated strains of EM were retrospective analysis in Xiasha Campus of Zhejiang Hospital of Traditional Chinese Medicine from September 2013 to September 2018.The infection characteristics and drug resistance were analyzed.RESULTS The 36 strains of EM were mainly from Intensive Care Unit(72.22%),followed by Hematology Department(8.33%)and Neurology Department(5.56%),which were mainly isolated from respiratory specimens such as sputum(83.33%),others were blood,catheters and ascites.The average age of patients with EM infection were 60 years old,and usually accompanied by respiratory diseases,brain diseases,and tumors et al.The drug susceptibility results displayed that resistance rate of EM was 100%to nitrofurantoin,all more than 97%toβ-lactams antibiotics including imipenem and ceftriaxone,and aminoglycosides antibiotics including amikacin and tobramycin,and over 83%to levofloxacin,ciprofloxacin and piperacillin/tazobactam.CONCLUSIONS The EM infected patients were almost elderly people,and accompanied by basic diseases.The isolated EM strains had a high resistance rate to the commonly used antibiotics such asβ-lactams and aminoglycosides.The clinical treatment might consider quinolone andβ-lactamase/inhibitor antibiotics.

关 键 词：脑膜败血伊丽莎白菌 感染 临床特征 抗菌药物 耐药率 

分 类 号：R378[医药卫生—病原生物学]