医院获得性感染多重耐药人苍白杆菌的临床特点、易感因素与耐药性研究  

Clinical characteristics,susceptibility factors and drug resistance of multidrug-resistant Ochrobactrum anthropi in hospital-acquired infections

作　　者：陈建飞 徐浩[2] CHEN Jian-fei;XU Hao(Laboratory Department of the Second Hospital of Jinhua,Jinhua Zhejiang 321000;Jinhua Central Hospital,China)

机构地区：[1]金华市第二医院,浙江金华321000 [2]金华市中心医院

出　　处：《中国消毒学杂志》2022年第5期358-362,共5页Chinese Journal of Disinfection

摘　　要：目的探讨多重耐药人苍白杆菌致医院获得性感染的临床特点、易感因素及耐药性,为临床抗感染治疗提供依据。方法回顾性分析2019—2021年某院住院治疗人苍白杆菌感染患者的临床资料。结果人苍白杆菌可引起多部位感染,主要来自血液(59.77%)和导管(31.03%),大多分布于外科重症监护室(27.59%)、感染科(24.14%)和儿科(18.39%)等。该菌感染患者多存在严重的基础疾病,临床症状不典型。机械通气、静脉留置导管、气管插管等是该菌感染的易感因素。该菌产AmpC酶率为90.80%,对哌拉西林、氨曲南、头孢呋辛、哌拉西林/他唑巴坦等抗菌药物的耐药率均高于90.00%,但对妥布霉素、左氧氟沙星、亚胺培南等抗菌药物的耐药率均低于10.00%,对头孢吡肟的耐药率低于30.00%。随着时间推移,多数抗菌药物的耐药率有逐年增高的趋势(P<0.05)。结论人苍白杆菌主要导致免疫力低下者发生导管相关性血流感染,临床应尽量减少有创性诊疗,该菌表现为多重耐药,与其高产AmpC酶有关,头孢吡肟可作为治疗该菌感染的首选经验用药。Objective To investigate the clinical characteristics,susceptibility factors and drug resistance of hospital-acquired infections caused by multidrug-resistant Ochrobactrum anthropi,and to provide scientific basis for clinical anti-infection treatment.Methods The clinical data of hospitalized patients with Ochrobactrum anthropi infection in our hospital from 2019 to 2021 were analyzed retrospectively.Results Ochrobactrum anthropi could cause multi-site infection,mainly from blood(59.77%)and catheters(31.03%),most of which were distributed in surgical intensive care unit(27.59%),infectious disease department(24.14%),pediatrics(18.39%),etc.Most of the patients infected with this bacteria had serious underlying diseases and the clinical symptoms were not typical.Mechanical ventilation,intravenous indwelling catheter and endotracheal intubation were the susceptibility factors for the infection.The AmpC enzyme production rate of the bacteria was 90.80%,and the resistance rates to antibiotics such as piperacillin,aztreonam,cefuroxime,piperacillin/tazobactam were higher than 90.00%,but the resistance rates to tobramycin,levofloxacin,imipenem and other antibiotics were lower than 10.00%,and the resistance rate to cefepime was lower than 30.00%.With the passage of time,the resistance rate of most antibiotics increased year by year(P<0.05).Conclusion Ochrobactrum anthropi mainly causes catheter-related bloodstream infection in immunocompromised patients,and invasive diagnosis and treatment should be minimized in clinical practice.The bacteria are multidrug-resistant,which is related to its high production of AmpC enzyme,and cefepime can be used as the first choice for the treatment of the bacterial infection.

关 键 词：人苍白杆菌 医院获得性感染 临床特点 易感因素 AMPC酶 耐药性 

分 类 号：R181.2[医药卫生—流行病学]