236株沙雷菌的临床分布及耐药性分析  

Clinical distribution and drug resistance analysis of 236 strains of Serratia

作　　者：胡莹[1] 陈群英[1] HU Ying;CHEN Qun-ying(Laboratory Department,Ningbo Women and Children's Hospital,Zhejiang 315012,China)

机构地区：[1]宁波市妇女儿童医院检验科,浙江315012

出　　处：《中国卫生检验杂志》2023年第11期1328-1330,共3页Chinese Journal of Health Laboratory Technology

摘　　要：目的了解沙雷菌在医院感染中的临床分布及耐药性分析。方法采用VITEK 2全自动微生物分析仪和配套的GNI、GNS-13,对236株沙雷菌进行分离鉴定和药敏试验,药敏结果使用WHONET 5.6软件进行分析。结果2012年1月—2021年12月共分离到沙雷菌236株,主要来源于呼吸道标本(61.44%),其次为血液(18.64%)和尿液(11.45%)。236株沙雷菌中黏质沙雷菌占绝大多数(88.56%),其次为居泉沙雷菌(6.36%)和液化沙雷菌(2.97%)。黏质沙雷菌对头孢唑啉和呋喃妥因耐药率均>99.0%,对复方新诺明耐药率为22.3%,对哌拉西林/他唑巴坦、三代、四代头孢菌素、庆大霉素、妥布霉素、阿米卡星、头孢替坦、喹诺酮类、氨曲南、碳青霉烯类敏感。结论三代喹诺酮可作为治疗由沙雷菌引起感染的首选药物,由于喹诺酮类药物对小儿骨骼生长有影响,不适宜于患儿和孕妇,可首选哌拉西林/他唑巴坦。沙雷菌耐药机制复杂,应重视对多重耐药沙雷菌的监控和控制,以减少耐药菌株的产生和院内扩散。Objective This paper aims to investigate the clinical distribution and drug resistance of Serratia in nosocomial infection.Methods A total of 236 strains of Serratia were isolated and identified by VITEK 2 automatic microbiological analy⁃zer and GNI and GNS-13.The drug sensitivity results were analyzed by WHONET 5.6 software.Results A total of 236 strains of Serratia were isolated from January 2012 to December 2021,mainly from respiratory specimens(61.44%),followed by blood(18.64%)and urine(11.45%).Among the 236 Serratia strains,Serratia marcescens accounted for the majority(88.56%),followed by Serratia juncea(6.36%)and Serratia liquefaciens(2.97%).The resistance rates of Serratia marces⁃cens to cefazolin and nitrofurantoin were greater than 99.0%,and the resistance rate to cotrimoxazole was 22.3%.It was sensi⁃tive to piperacillin/tazobactam,third-generation and fourth-generation cephalosporin,gentamicin,tobramycin,amikacin,cefotetan,ouronone,aztreonam and carbapenems.Conclusion The third-generation ouarone can be used as the first choice for the treatment of infection caused by Serratia.Because of its effect on the growth of bone and ilium in children,ouarone is not suitable for children and pregnant women,and piperacillin/tazobactam can be the first choice.The mechanism of drug resist⁃ance of Serratia is complex,so we should pay attention to the monitoring and control of multidrug-resistant Serratia in order to reduce the production of drug-resistant strains and nosocomial spread.

关 键 词：医院感染 沙雷菌 耐药性 

分 类 号：R446.5[医药卫生—诊断学]