1例输入性类鼻疽病例病原学特征及耐药分析  

Etiological characteristics and antimicrobial resistance analysis of an import melioidosis case in Beijing

作　　者：梁志超[1] 乔富宇[2] 王小梅[1] 李爽[1] 窦相峰[1] 曲梅[1] 吕冰[1] 李夫 金昊源 张新[1] 任振勇[1] 林长缨[1] LIANG Zhichao;QIAO Fuyu;WANG Xiaomei;LI Shuang;DOU Xiangfeng;QU Mei;LÜBing;LI Fu;JIN Haoyuan;ZHANG Xin;REN Zhenyong;LIN Changying(Beijing Center for Disease Prevention and Control,Beijing 100013,China;不详)

机构地区：[1]北京市疾病预防控制中心,100013 [2]北京市西城区疾病预防控制中心

出　　处：《首都公共卫生》2024年第3期181-184,共4页Capital Journal of Public Health

摘　　要：目的 描述1例境外输入类鼻疽患者的流行病学特征、实验室诊断和耐药性特征,为类鼻疽的监测、诊断治疗及防控提供依据。方法 收集患者流行病学调查信息,采集患者全血、血清、尿液、皮疹部位涂抹拭子及肺泡灌洗液样本进行细菌分离培养。培养物采用生化试验进行鉴定,使用肉汤稀释法药敏试验分析耐药情况。结果 患者皮疹部位涂抹拭子及肺泡灌洗液样本经过72 h分离培养,从皮肤涂抹拭子及肺泡灌洗液的样本中分离到2株菌株,经生化鉴定确定为类鼻疽伯克霍尔德菌。耐药性分析显示,该菌株对头孢唑啉、头孢噻肟、庆大霉素、多黏菌素B、氨曲南和链霉素6种药物耐药,患者经治疗后痊愈出院。结论 疾病诊断应关注患者旅行史和接触史,细菌性疾病应关注菌株耐药情况。Objective To describe the epidemiological characteristics,laboratory diagnostic result and antimicrobial resistance(AR)features of an imported melioidosis case from aboard in Beijing,so as to provide evidences for the prevention and control of melioidosis.Methods The result of epidemiological investigation of the patient and whole blood,serum,urine,swabs of skin lesion and bronchoalveolar lavage fluid(BALF)samples were collected for bacterial culture isolation.The culture was identified by biochemical tests.The mini broth dilution susceptibility test method was used for AR analysis.Results Two bacterial strains were obtained after 72 h bacterial culture from one skin swab sample and the BALF sample,respectively.The stains were identified as Burkholderia pseudomallei(BP)by the biochemical tests.The AR assay indicated that both strains were resistant to 6 antibiotics,including cefazolin,cefataxime,gentamicin,polymixin B,aztreonam and streptomycin.The patient were patient was cured and discharged from the hospital.Conclusions The clinical diagnosis should concern travelling history and contact history of the patient.Antimicrobial resistant of the bacterial strains should also be noticed in bacterial diseases.

关 键 词：类鼻疽 类鼻疽伯克霍尔德菌 分离鉴定 耐药性 

分 类 号：R535[医药卫生—内科学] R446[医药卫生—临床医学]