结核病患者感染产吲哚金黄杆菌的快速鉴定及药敏分析  

Rapid identification and drug sensitivity analysis of Chryseobacterium indologenes in tuberculosis patients

作　　者：薛建昌 孙红梅[1] 孙志平[1] 吴海峰[1] 刘军利 徐美丽[1] XUE Jianchang;SUN Hongmei;SUN zhiping;WU Haifeng;Liu junli;XU Meili(Department of Laboratory,Hebei chest Hospital,Shijiazhuang 050041,China;不详)

机构地区：[1]河北省胸科医院检验科,石家庄050041 [2]石家庄市人民医院导管室

出　　处：《医学动物防制》2023年第6期609-612,F0003,共5页Journal of Medical Pest Control

基　　金：河北省医学科学重点课题(20170424)。

摘　　要：目的通过分析结核病患者感染产吲哚金黄杆菌(Chryseobacterium indologenes)的鉴定和药敏试验,为临床快速诊断及合理用药提供依据。方法收集2020年1月至2022年6月在河北省胸科医院就诊的结核病病例标本,包含痰标本14例,支气管肺泡灌洗液7例。应用Bruker质谱仪鉴定出合并感染产吲哚金黄杆菌21例,用BD Phoenix^(TM)-100系统检测抗菌药物的敏感性。结果本次试验21例标本的药敏结果显示,碳青霉烯类、头孢类、氨基糖甙类抗生素耐药率均达90.0%以上。敏感性最高的抗生素是复方磺胺甲噁唑、米诺环素和莫西沙星,敏感度分别是90.5%、52.4%、47.6%。超广谱β-内酰胺酶(extended spectrumβlactamase,ESBL)19株,检出率90.5%。多重耐药20株,检出率95.2%,耐碳青霉烯类全部表现为超广谱β-内酰胺酶耐药。结论结核病患者感染产吲哚金黄杆菌耐药率高,治疗时应优先选用复方磺胺甲噁唑、米诺环素和莫西沙星。Objective By analyzing the identification and drug sensitivity test of Chryseobacterium indologenes in tuberculosis patients,this study provides a basis for rapid clinical diagnosis and rational drug use.Methods Specimens of tuberculosis patients presented to the Chest Hospital of Hebei Province from January 2020 to June 2022 were collected,including 14 cases of sputum samples and 7 cases of bronchoalveolar lavage fluid.Bruker mass spectrometer was used to identify 21 cases of C.indologenes.BD Phoenix^(TM)-100 system was used to detect the sensitivity of antimicrobials.Results The drug sensitivity results of 21 cases in this test showed that the drug resistance rates of carbapenems,cephalosporins,and aminoglycosides were all over 90.0%.The most sensitive antibiotics were the compound sulfa,minocycline,and moxifloxacin,with a sensitivity of 90.6%,52.4%and 47.6%,respectively.There were 19 strains of extended-spectrumβ-lactamase(ESBL),with a detection rate of 90.5%.There were 20 multi-resistant strains,with a detection rate of 95.2%,and all carbapenem-resistant showed ESBL resistance.Conclusion The drug resistance rate of C.indologenes in tuberculosis patients is high,and treatment should be given priority with the compound sulfamethoxazole,minocycline,and moxifloxacin.

关 键 词：结核病 产吲哚金黄杆菌 Bruker质谱仪 BD Phoenix^(TM)-100系统 耐药性 分析 

分 类 号：R446.5[医药卫生—诊断学] R52[医药卫生—临床医学]