呼吸道感染嗜麦芽寡养单胞菌的临床及耐药分析

Stenotrophomonas maltophilia in Respiratory Tract Infection:Its Clinical Factors and Antimicrobial Drug-resistance

目的探讨呼吸道感染嗜麦芽寡养单胞菌的危险因素和耐药情况。方法收集经痰或呼吸道分泌物培养分离出的56株嗜麦芽寡养单胞菌的耐药结果分析,复习相关临床资料,解析其危险因素。结果对12 种抗菌药物的耐药最低依次为复方磺胺甲噁唑7. 1%、头孢哌酮/舒巴坦33. 3%,诺氟沙星42 .9%,有9种抗菌药物的耐药率>50%。结论嗜麦芽寡养单胞菌成为呼吸道医院感染的重要致病菌,多发生在免疫力低下的老年人,慢性、长期接受广谱抗生素治疗的患者,一旦造成感染,可选用的抗生素极少,治疗相当困难。

OBJECTIVE To study the risk factors in patients of respiratory tract infected with Stenotrophomonas maltophilia and the antimicrobial agents. METHODS Fifty six strains of S. maltophilia were collected from patients′ sputa or the respiratory tract secretion. In vitro drug susceptibility was evaluated by microdilution minimal inhibitory concentration. RESULTS Twelve kinds of antibiotics were tested in vitro susceptible tests. The data showed that 7.1% of isolates were resistant to sulfamethoxazole(SMZ), 33.3% of the isolates were resistant to cefoperazone, 42.9% of strains were resistant to ciprofloxacin. There were over 50% of strains resistant to the other 9 kinds of antibiotics. CONCLUSIONS These data indicated that S. maltophilia is multidrug-resistant. The patients with such condition as long time use of antibiotic, steroids treatment, and malignancy invasion, may all be predisposed to S. maltophilia infection. After being infected with S. maltophilia, patients are very difficult to be treated due to few antibiotic choice.