黏质沙雷菌在环湖医院的感染现状  

Status of Serratia marcescens infection in Huanhu Hospital

作　　者：高贺桢 胡静仪[1] 张飚[1] Gao Hezhen;Hu Jingyi;Zhang Biao(Tianjin Huanhu Hospital,Tianjin 300350,China)

机构地区：[1]天津市环湖医院,天津300350

出　　处：《首都食品与医药》2023年第11期73-76,共4页Capital Food Medicine

摘　　要：目的回顾分析天津市环湖医院2017年-2021年5年间,648株黏质沙雷菌的分布状况,对比分析常见抗生素的耐药性,为临床医生合理应用抗生素提供有力帮助.方法采用梅里埃公司VITEK?MS微生物质谱鉴定系统;药敏试验采用梅里埃公司VITEK■-2 compac GN药敏卡,以及CLSI推荐的KB药敏纸片扩散法.结果针对β内酰胺类药物,黏质沙雷菌的药物敏感性不高,头孢泊肟、头孢噻肟、头孢曲松(三代头孢),以及替卡西林、哌拉西林的耐药率远高于其他,其中以头孢泊肟的耐药率最高,为73.06%,与其他类别抗生素耐药率比较,存在显著差异(P<0.01).而氨曲南、头孢唑肟、头孢吡肟、替卡西林/克拉维酸、头孢哌酮/舒巴坦耐药率呈现逐年增加的趋势;碳青霉烯类抗生素的敏感性有所下降,敏感性最高的为多尼培南,为92.12%;针对喹诺酮类药物,三代药物左氧氟沙星、诺氟沙星要比四代莫西沙星的敏感性高;在所有抗生素里面,阿米卡星的敏感性最高,为98.18%,其次是多尼培南92.12%.结论阿米卡星、多尼培南、美罗培南、厄他培南、哌拉西林/他唑巴坦药物敏感性较好,特别是阿米卡星,可作为经验首选用药.这与2021年中国耐药监测网发布的黏质沙雷菌对常规抗生素的耐药率统计是基本一致的,可以给临床在治疗黏质沙雷菌引起的感染中起到一定的指导作用.Objective To review the distribution of 648 strains of Serratia mucoidesi n our hospital during the five years from 2017 to 2021,and compare and analyze the resistance of common antibioicts,so as to provide strong help for clinicians to rationallyu se antibiotics.Methods The VITEK®MS microbial mass spectrometry system was used.VITEK®-2 compac GN drug sensitive card of Meriere and KB drug sensitive disk diffusion method recommended by CLSI were used for drug sensitive test.Results Forβlactam drugs,Serratia marcescens had low drug sensitivity,and the drug resistance rates of cefpoxime,cefotaxime,ceftriaxone(third-generation cefotaxime),ticacillin and piperacillin were much higher than others,among which the drug resistance rate of cefpoxime contamination wast he highest,which was 73.06%.Compared with other antibiotics,there was a significant difference P(<0.01).The drug resistance rates of amtriaxam,cefazoxime,cefepime,ticacillin/clavulanate,cefoperazone/sulbactam showed an increasing trend year by year.The esnsitivity of carbapenems decreased,and the highest sensitivity was Donipenem(92.12%).For quinolones,the third-generation levofloxacin and norfloxacin were more sensitive than the fourth-generation moxfiloxacin.Amikacin had the highest sensitivity of all antibiotcis,98.18%,followed by Donipenem 92.12%.Conclusion Amikacin,Donipenem,meropenem,ertapenem,piperacillin/tazobactam have good drug sensitivity,especially amikacin,which can be used as the firts choice for experience.This is basically consistent with thes tatistics of the resistance rate of Serratia marcescens to conventional antibiotics released by China Drug Resistance Monitoring Network in 2021,it can play a guiding role in the treatment of Serratia marcescens infection.

关 键 词：黏质沙雷菌 分布 耐药性 敏感性 

分 类 号：R978.1[医药卫生—药品]