2018—2022年嗜麦芽窄食单胞菌的临床分布和耐药性分析  

Analysis of Clinical Distribution and Drug Resistance of Stenotmphomonas Maltophilia from 2018 to 2022

作　　者：牛慧云[1] 杜志强[1] 王全哲[1] 赵文渊 边慧[1] 于敬达[2] NIU Huiyun;DU Zhiqiang;WANG Quanzhe;ZHAO Wenyuan;BIAN Hui;YU Jingda(Department of Pharmacy,the Third Affiliated Hospital of Baotou Medical College,Baotou 014030,Inner Mongolia,China;Department of Clinical Laboratory,Baotou Medical College,Baotou 014060,Inner Mongolia,China)

机构地区：[1]包头医学院第三附属医院药学部,内蒙古包头014030 [2]包头医学院医学技术学院,内蒙古包头014060

出　　处：《中国药物滥用防治杂志》2023年第11期1917-1921,1925,共6页Chinese Journal of Drug Abuse Prevention and Treatment

基　　金：包头医学院科研基金项目青苗计划(编号:byjj-gyqm002)。

摘　　要：目的:分析嗜麦芽窄食单胞菌临床分布的特征及耐药性变迁,为临床的抗感染治疗方案提供参考。方法:回顾性分析某三级综合医院2018年1月—2022年12月住院患者分离出嗜麦芽窄食单胞菌细菌的分布及药敏情况,通过Whonet 5.6进行统计学分析。结果:2018—2022年共分离出嗜麦芽窄食单胞菌438株,分离率由4.09%上升至6.42%,呈逐年上升趋势。分离菌株主要来自60岁以上老年患者,占84.47%。样本主要来源是痰液和肺泡灌洗液,分别占89.95%和5.71%。分离率前3位的临床科室为呼吸科(162株,36.98%)、重症医学科(69株,15.75%)和老年病科(38株,8.68%)。体外药敏试验结果表明,嗜麦芽窄食单胞菌对米诺环素、复方新诺明、左氧氟沙星和氯霉素耐药率较低,分别为2.13%、8.22%、11.45%和17.12%,5年间耐药率变化无统计学意义(P>0.05),嗜麦芽窄食单胞菌对头孢他啶耐药率较高(39.01%),且2021—2022年呈现上升趋势,及耐药率波动有统计学意义(P<0.01)。结论:嗜麦芽窄食单胞菌的分离率逐年增高,且对部分抗菌药物的耐药率出现波动,临床治疗中应加强嗜麦芽窄食单胞菌的预防与控制,根据药敏试验结果来合理选择抗菌药物。Objective:To analyze the clinical distribution characteristics and drug resistance changes of Stenotrophomonas maltophilia,and to provide reference for clinical anti-infection treatment.Methods:The distribution and drug sensitivity of Stenotrophomonas maltophilia isolated from inpatients in a tertiary general hospital from January 2018 to December 2022 were retrospectively analyzed,and statistical analysis was performed by Whonet 5.6.Results:A total of 438 strains of Stenotrophomonas maltophilia were isolated from 2018 to 2022,and the isolation rate increased from 4.09%to 6.42%,showing an increasing trend year by year.The isolated strains were mainly from elderly patients over 60 years old,accounting for 84.47%.The main sources of samples were sputum and alveolar lavage fluid,accounting for 89.95%and 5.71%,respectively.The top three clinical departments with the highest isolation rate were respiratory department(162 strains,36.98%),intensive care unit(69 strains,15.75%)and geriatrics department(38 strains,8.68%).The results of in vitro drug sensitivity test showed that the resistance rates of Stenotrophomonas maltophilia to minocycline,cotrimoxazole,levofloxacin and chloramphenicol were low,which were 2.13%,8.22%,11.45%and 17.12%,respectively.There was no significant change in the resistance rate during the five years(P>0.05).The resistance rate of Stenotrophomonas maltophilia to ceftazidime was high(39.01%),and it showed an upward trend from 2021 to 2022,and the fluctuation of resistance rate was statistically significant(P<0.01).Conclusion:The isolation rate of Stenotrophomonas maltophilia increased year by year,and the resistance rate to some antibiotics fluctuated.The prevention and control of Stenotrophomonas maltophilia should be strengthened in clinical treatment,and antibiotics should be reasonably selected according to the results of drug sensitivity test.

关 键 词：嗜麦芽窄食单胞菌 分离率 耐药性 抗菌药物 

分 类 号：R446.5[医药卫生—诊断学]