69例嗜麦芽窄食单孢菌院内感染危险因素分析及其耐药性监测

Analysis of risk factors in 69 patients with nosocomial infection caused by Stenotrophomonas maltophilia and monitor of drug resistance in 117 strains of this bacteria

目的了解嗜麦芽窄食单孢菌的医院感染的危险因素及其耐药性变化,为预防其感染和临床合理用药提供依据。方法回顾性分析该院嗜麦芽窄食单孢菌医院感染病例69例的临床特点,监测该院嗜麦芽窄食单孢菌117株的药敏结果。结果69例嗜麦芽窄食单孢菌院内感染危险因素有:高龄、住院时间长、使用广谱抗生素、有严重基础疾病、创伤性操作。对117株嗜麦芽窄食单孢菌耐药性监测结果:该菌对复方新诺明、环丙沙星、奈啶酸、氯霉素、头孢哌酮/舒巴坦耐药率较低,均低于50%。对大多数半合成青霉素及头孢菌素高度耐药。对亚胺培南,美洛培南耐药率接近100%。对头孢他啶,庆大霉素,阿米卡星耐药性略有上升趋势。结论缩短住院天数、严格掌握各种侵入性操作指征、合理使用抗菌药物、积极治疗基础疾病并监测细菌耐药性及时调整用药有利于防治该类细菌感染。

[Objective] To investigate the risk factors of nosocomial infection caused by Stenotrophomonas maltophilia and its variation in drug resistance,in order to provide essential basis for preventing and treating it.[Methods] The clinical characteristics of nosocomial infection caused by Stenotrophomonas maltophilia were retrospectively analyzed among the 69 cases from 2000 to june in 2005 in our hospital and monitor the meanwhile drug sensitivity results of 117 strains of Stenotrophomonas maltophilia.[Results] Risk factors of these infections including,old age,long time hospitalization,use of broad spectrum antibiotics,underlying diseases and tramatic manipulation.Monitor results of drug resistance in 117 strains of Stenotrophomonas maltophilia：these strains were lower than 50% drug resistance rate to SMZco,ciprofloxacin,nalidixic acid,chloramphenicol,cefoperazone/sulbactam,and high rate to semisynthetic penicillins and cephalosporin,and nearly 100% resistance to imipenem and meropenem.The resistance rate to ceftazidime,gentamicin and amikacin is gradually increasing.[Conclusions] Reducing in-hospital time,strictly controlling indication of invasive maniculation,appropriately using antibiotics,actively treating underlying diseases,monitoring drug resistance of bacteria and promptly adapting the drug are all useful to prevent nosocomial infection caused by Stenotrophomonas maltophilia.