湛江地区类鼻疽伯克霍尔德菌特征与流行病学研究

Study on characteristics and epidemiology of Burkholderia pseudomallei in Zhanjiang area

目的研究类鼻疽伯克霍尔德菌与常见其他伯克霍尔德菌间病原学特点及对药物敏感性的差异,为临床诊断、检验和治疗提供参考。方法对类鼻疽伯克霍尔德菌感染病例进行流行病学研究,并将其与常见医院感染皮氏伯克霍尔德菌、洋葱伯克霍尔德菌对常用抗菌药物的药敏结果进行比较分析。结果类鼻疽伯克霍尔德菌具有两端浓染,银白色菌落形态特征。在湛江,此菌感染以遂溪、廉江、吴川为主要疫区,好发于秋季,接触疫水、农民、免疫功能低下、年龄≥50岁为易感因素。其对复方磺胺甲口恶唑、头孢哌酮/舒巴坦、米诺环素、哌拉西林及其酶抑制复合制剂、头孢他啶、亚胺培南敏感率达100%,对氨基糖苷类、喹诺酮类和非抗假单胞菌属类药敏感性较差或耐药。结论类鼻疽伯克霍尔德菌感染属热带或亚热带地区传染病,水患易导致该菌流行;细菌具有染色、菌落形态特征,对药物的敏感性具有伯克菌属共同特征,易产生耐药,建议联合用药治疗。

Objective To study the differences in pathogenic characteristics and antimicrobial susceptibility between Burkholderia pseudomallei and the other Burkholderia strains, and offer information for clinical diagnosis , therapy and laboratory test. Methods Epidemiologic study on diseases caused by Burkholderia was performed , and antimicrobial susceptibility tests of Burkholderia pseudomallei , Burkholderia pickettii and Burkholderia cepacia in nosocomial infections were compared and analysed. Results The morphology of Burkholderia pseudomallei colonies were characterized by strong staining on each side and silver white colour, the major epidemic areas of infectious diseases caused by Burkholderia pseudomallei in Zhanjiang were Suixi, Lianjiang and Wuchuan, diseases usually occurred in autumn, the risk factors of diseases were contacting epidemic water, farmers, hypoimmunity persons, age 950. The sensitive rates of Burkholderia pseudomallei to trimethoprim/sulfamethoxazole, cefoperazone/sulbactam, minocycline, piperacillin, piperacillin/tazobactam, ceftazidime and imipenem were all 100%, and its sensitive rates to aminoglycosides, quinolones, non-anti-pseudomonas antimicrobial agents were low. Conclusion Burkholderia pseudomallei infections belong to infectious diseases in tropical or subtropical zone, which is easily spread by flood, aod had its own staining and morphologic characteristics, antimicrobial susceptibility is similar to all Burkholderia strains, resistance to antimicrobial agents is high, and combination antimicrobial agents for the treatment should be used.