2011-2019年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 Stenotrophomonas maltophilia from 2011 to 2019

作　　者：王瑜[1,2] 王丽凤 常悦 杨继勇 韩瑞 王成彬[1,2] WANG Yu;WANG Lifeng;CHANG Yue;YANG Jiyong;HAN Rui;WANG Chengbin(Hebei North University,Zhangjiakou,Hebei 075000,China;Department of Clinical Laboratory,the First Medical Center of Chinese PLA General Hospital,Beijing 100853,China)

机构地区：[1]河北北方学院,河北张家口075000 [2]中国人民解放军总医院第一医学中心检验科,北京100853

出　　处：《国际检验医学杂志》2021年第23期2910-2913,共4页International Journal of Laboratory Medicine

摘　　要：目的调查中国人民解放军总医院第一医学中心患者分离的嗜麦芽窄食单胞菌(PMA)在临床标本中的分布及耐药性变迁,为临床医生合理使用抗菌药物提供参考依据。方法收集2011-2019年中国人民解放军总医院第一医学中心患者送检的各类标本中分离的PMA,采用VITEK 2 Compact细菌鉴定系统或VITEK MS质谱仪进行细菌鉴定,抗菌药物药敏试验采用K-B法,数据采用WHONET 5.6软件进行分析。结果去除同一患者同一部位分离的重复菌株,共分离PMA 2395株,该菌在中老年(>60岁)患者中分离率较高,占67.7%;菌株主要来源于下呼吸道标本(71.8%),其次是尿液标本(7.3%)、引流液(6.2%)、血液(2.8%)。PMA分离数量前3位的科室分别为呼吸科、神经内科和急诊科。在美国临床和实验室标准协会推荐的几种抗菌药物中,PMA对复方磺胺甲噁唑、左氧氟沙星和米诺环素耐药率均比较低,分别为1.4%~8.7%、7.5%~14.6%、0.0%~1.3%。不同标本来源的菌株耐药率存在差异,下呼吸道标本和尿液标本中分离的菌株对左氧氟沙星耐药率较高,分别为11.9%和17.3%;血液标本分离的菌株对复方磺胺甲噁唑和左氧氟沙星具有较高的耐药率,均为9.1%。结论不同标本类型分离的菌株对常用抗菌药物的耐药率存在差异,临床应积极开展细菌耐药性监测,为临床治疗提供用药的参考信息,有助于减少经验性用药,对不同分离部位的菌株选用敏感性较高的药物,有助于减少在大量抗菌药物使用压力下产生的多耐药细菌。Objective To investigate the distribution and drug resistance changes of Stenotrophomonas maltophilia(PMA)isolated from patients in the First Medical Center of Chinese PLA General Hospital in clinical specimens,and to provide reference for the rational use of antibacterial drugs by clinicians.Methods Collected PMA separated from various specimens submitted by patients at the First Medical Center of Chinese PLA General Hospital from 2011 to 2019,used VITEK 2 Compact bacterial identification system or VITEK MS mass spectrometer for bacterial identification,K-B method was used for antimicrobial drug susceptibility test,and the data were analyzed by WHONET 5.6 software.Results Removed the duplicate strains isolated from the same part of the same patient,and isolated PMA 2395 strains.The isolation rate of the bacteria in middle-aged and elderly patients(>60 years old)was relatively high,accounting for 67.7%.Strains were mainly derived from lower respiratory tract specimens(71.8%),followed by urine specimens(7.3%),drainage fluid(6.2%),and blood(2.8%).The top 3 departments in the number of PMA were respiratory department,neurology department and emergency department.Among the several antibacterial drugs recommended by the American Clinical and Laboratory Standards Institute,the resistance rates of PMA to compound sulfamethoxazole,levofloxacin and minocycline were relatively low,respectively 1.4%-8.7%,7.5%-14.6%,0.0%-1.3%.The drug resistance rates of strains from different specimen sources were different.The strains isolated from lower respiratory tract specimens and urine specimens had high resistance to levofloxacin,which were 11.9%and 17.3%,respectively;the strains isolated from blood specimens had high resistance rates to compound sulfamethoxazole and levofloxacin,both of which were 9.1%.Conclusion Strains isolated from different specimen types have different resistance rates to commonly used antibacterial drugs.The clinic should actively carry out bacterial resistance monitoring to provide reference information on m

关 键 词：嗜麦芽窄食单胞菌 临床分布 耐药性 抗菌药物 

分 类 号：R446.5[医药卫生—诊断学]