医院感染脑膜败血伊丽莎白菌的临床特点、产酶情况与耐药性分析  

Analysis of clinical characteristics,enzyme production and drug resistance of hospital infection caused by Elizabethkingia meningospetica

作　　者：俞容 徐娇君[1] 金东芳 谭文敏 YU Rong;XU Jiao-jun;JIN Dong-fang;TAN Wen-min(Clinical Laboratory,Jinhua People’s Hospital,Jinhua,Zhejiang 321000,China)

机构地区：[1]金华市人民医院检验科,浙江金华321000

出　　处：《中国卫生检验杂志》2020年第24期2967-2970,共4页Chinese Journal of Health Laboratory Technology

基　　金：金华市科技局创新基金项目(2019-4-054)。

摘　　要：目的探讨医院感染脑膜败血伊丽莎白菌(EM)的临床特点、产酶情况与耐药性,为临床抗感染治疗提供参考。方法回顾性分析2015年1月-2019年12月金华市人民医院EM感染患者的临床资料。结果 EM主要感染对象为年龄≥60岁、合并有严重的基础疾病、疾病危险等级评分≥4分、接受过侵入性诊疗、有近期手术史、使用广谱抗菌药物和(或)激素时间≥2周、住院时间≥4周的患者。91株EM主要来自痰液标本(81.3%),主要分布于ICU、呼吸内科和肿瘤内科,分别占35.1%、26.4%和20.9%。所有EM均产ESBLs,79.1%产MBL。药敏试验结果表明,EM对氨基糖甙类、碳青霉烯类和大多数β-内酰胺类抗菌药物的耐药率达70.0%以上。结论高龄、伴有严重的基础疾病、接受侵入性诊疗、使用广谱抗菌药物与激素、长时间住院是引起EM感染的主要危险因素,EM多重耐药现象严重与其高产ESBLs、MBL相关。Objective To explore the clinical characteristics,enzyme production and drug resistance of eizabethkingia meningospetica( EM) in nosocomial infection,and provide reference for clinical anti infection treatment.Methods The clinical data of patients with EM infection in Jinhua People’s Hospital from January 2015 to December 2019 were analyzed retrospectively.Results The main infected subjects of EM were patients with age ≥ 60 years old,complicated with serious basic diseases,disease risk rating score( score) ≥ 4 points,who had received invasive diagnosis and treatment,who had recent operation history,who used broad-spectrum antibiotics and/or hormones for ≥ 2 weeks,and who were hospitalized for ≥ 4 weeks.A total of 91 EM strains were detected from sputum samples( 81.3%),mainly distributed in ICU,respiratory medicine and oncology medicine,accounting for 35.1%,26.4% and 20.9% respectively.All EM produced ESBLs,and 79.1% produced MBL.The results of drug sensitivity test showed that the drug resistance rate of EM to aminoglycosides,carbapenems and mostβ-lactams was over 70%.Conclusion The main risk factors of EM infection are old age,serious basic diseases,invasive diagnosis and treatment,use of broad-spectrum antibiotics and hormones,long-term hospitalization.The multiple drug resistance of EM is serious,and related to the high production of ESBLs and MBL.

关 键 词：脑膜败血伊丽莎白菌 医院感染 临床特点 产酶情况 耐药性 

分 类 号：R446.5[医药卫生—诊断学]