临床感染标本厌氧菌质谱鉴定及临床特征  

Mass Spectrometry Identification and Clinical Characteristics of Anaerobic Bacteria in Clinical Infection Specimens

作　　者：张峻梅[1] 杨莉莉[1] 刘敏[1] 冯小艳[1] 杨菊艳 李霜 彭溪[1] 张航[1] Zhang Junmei;Yang Lili;Liu Min(Department of Laboratory Medicine,the Third People′s Hospital of Chengdu,Chengdu,Sichuan 610031,China)

机构地区：[1]成都市第三人民医院临床医学检验部,四川成都610031

出　　处：《四川医学》2024年第9期978-982,共5页Sichuan Medical Journal

摘　　要：目的探讨我院厌氧菌感染的种属分布、耐药性和临床特征,为临床治疗提供参考。方法收集2020年1月至2023年6月从临床感染标本中分离的非重复感染部位、非重复株厌氧菌菌株248株。采用MALDI-TOF MS技术鉴定厌氧菌种属,采用天地人微生物检测系统进行药敏试验和β-内酰胺酶实验,并进行临床分析。结果共分离248株厌氧菌,分属13个属,以拟杆菌属(44.4%)、普雷沃菌属(16.1%)和消化链球菌属(15.3%)为主。拟杆菌属中脆弱拟杆菌(74.5%)最多,主要来自分泌物、脓液和静脉血。脆弱拟杆菌对甲硝唑、氯霉素、头孢西丁、头孢三代药物、碳青霉烯类药物和β-内酰胺类复合药药物的敏感率均>85%。青霉素、氨苄西林耐药率为100%。对四环素和克林霉素耐药率>50%。β-内酰胺酶阳性率100%。结论厌氧菌是重要的感染病原体,其耐药性明显增加。实验室应加强对厌氧菌的鉴定和药敏试验指导临床合理用药,提高治疗效果。Objective To investigate the species distribution,antimicrobial resistance and clinical characteristics of anaerobic bacterialanaerobic infections in our hospital,and to provide reference for clinical treatment.Methods Total 248 non-redundant strains from non-redundant infection sites were collected from clinical infection specimens from January 2020 to June 2023.Species of anaerobic bacteria were identified using MALDI-TOF MS technology.Antimicrobial susceptibility tests andβ-lactamase tests were conducted using the Tiandi Ren Microbial Detection System,and clinical analyses were performed.Results All 248 strains of anaerobic bacteria were isolated,belonging to 13 genera,with the predominant ones being Bacteroides(44.4%),Prevotella(16.1%),and Peptostreptococcus(15.3%).Among the Bacteroides genus,Bacteroides fragilis(74.5%)was the most common,primarily isolated from secretions,pus,and venous blood.Bacteroides fragilis showed a susceptibility rate of>85%to metronidazole,chloramphenicol,cefoxitin,third-generation cephalosporins,carbapenems,andβ-lactam/β-lactamase inhibitor combinations.The resistance rates to penicillin and ampicillin were 100%.The resistance rates to tetracycline and clindamycin were over 50%,and theβ-lactamase positive rate was 100%.Conclusion Anaerobic bacteria are significant infectious pathogens with noticeably increasing antibiotic resistance.Laboratories should enhance the identification of anaerobic bacteria and guide clinical medication through antimicrobial susceptibility testing to improve treatment outcomes.

关 键 词：厌氧菌 脆弱拟杆菌 基质辅助激光解析电离飞行时间质谱 药物敏感试验 β-内酰胺酶实验 

分 类 号：R446.5[医药卫生—诊断学]