结核患者感染非脱羧勒克菌的快速鉴定及药敏试验分析  

Rapid identification and drug sensitivity test of Leclercia adecarboxylata in tuberculosis patients

作　　者：刘军利 乔晓慧 盖芳[3] 迟峰 王红[4] 薛建昌 LIU Junli;QIAO Xiaohui;GE Fang;CHI Feng;WANG Hong;XUE Jianchang(Catheter Room,People's Hospital of Shijiazhuang City,Hebei 050000,China;不详)

机构地区：[1]石家庄市人民医院导管室,河北050000 [2]石家庄市人民医院影像中心 [3]石家庄市第五医院超声科 [4]河北省胸科医院输血科 [5]河北省胸科医院检验科

出　　处：《医学动物防制》2023年第3期227-230,共4页Journal of Medical Pest Control

基　　金：河北省医学科学重点课题(20211553)。

摘　　要：目的探讨结核(tuberculosis)患者感染非脱羧勒克菌(Leclercia adecarboxylata)的快速诊断和耐药状况。方法应用基质辅助激光解吸电离飞行时间质谱(matrix-assisted laser desorption ionization time-of-flight mass spectrometry,MALDI-TOF MS)技术筛选2019年6月至2022年6月在某医院就诊的结核患者标本,采用全自动微生物分析仪PhoenixTM-100进行21种常规药物敏感性试验。结果共收集26例非脱羧勒克菌的药敏结果,结果显示非脱羧勒克菌致病力较弱,对阿米卡星、头孢他啶、环丙沙星、多粘菌素、左氧氟沙星、哌拉西林/他唑巴坦、氨苄西林/舒巴坦敏感率均为100.0%。对头孢吡肟、头孢噻肟、庆大霉素、亚胺培南、美罗培南、阿莫西林/克拉维酸钾、莫西沙星、复方磺胺、氨曲南敏感率均>80.0%。耐药性居前3位的是氨苄西林、头孢唑林和四环素,耐药率分别为26.9%(7/26)、23.1%(6/26)和19.2%(5/26)。结论结核患者更易感染非脱羧勒克菌;MALDI-TOF MS对非脱羧勒克菌等罕见细菌的快速鉴定有显著优势;非脱羧勒克菌毒力较弱,耐药率较低。Objective To investigate the rapid diagnosis and drug resistance of Leclercia adecarboxylata infection in tuberculosis patients.Methods Matrix-assisted laser desorption ionization time-of-flight mass spectrometry(MALDI-TOF MS)was used to screen the specimens of tuberculosis patients who were hospitalized in a hospital from June 2019 to June 2022,and the full-automatic microbiological analyzer PhoenixTM-100 was used to 21 kinds of conventional drug sensitivity test.Results A total of 26 cases of Leclercia adecarboxylata were collected showed that the pathogenicity of Leclercia adecarboxylata was weak,and the sensitivity rates of amikacin,ceftazidime,ciprofloxacin,polymyxin,levofloxacin,piperacillin/tazobactam,and ampicillin/sulbactam were 100.0%.The sensitivity rates of cefepime,cefotaxime,gentamicin,imipenem,meropenem,amoxicillin/clavulanate potassium,moxifloxacin,compound sulfa,and aztreonam were all>80.0%.The top three drug resistance were ampicillin,cefazolin,and tetracycline,with drug resistance rates of 26.9%(7/26),23.1%(6/26),and 19.2%(5/26),respectively.Conclusion Tuberculosis patients are more susceptible to Leclercia adecarboxylata;MALDI-TOF MS has a significant advantage for the rapid identification of rare bacteria such as Leclercia adecarboxylata,Leclercia adecarboxylata has weak virulence and low drug resistance.

关 键 词：非脱羧勒克菌 结核患者 快速鉴定 药敏试验 基质辅助激光解吸电离飞行时间质谱 

分 类 号：R446[医药卫生—诊断学] R52[医药卫生—临床医学]