32株纹带棒杆菌的感染及其耐药分析

Identification and Resistance Analysis of 32 Strains of Corynebacterium striatum Clinical Isolates

目的了解纹带棒杆菌感染在临床标本中的分布以及药物敏感情况,指导临床用药。方法纹带棒杆菌的鉴定采用法国生物梅里埃公司API Coryne鉴定系统,用琼脂稀释法测定20种抗菌药物的最低抑菌浓度(MIC)。结果32株纹带棒杆菌主要标本来源为痰,ICU分离率最高;亚胺培南、万古霉素、利福平对该菌有较高的敏感性;阿米卡星、庆大霉素、妥布霉素、米诺环素等次之;而β-内酰胺酶及β-内酰胺酶加酶抑制剂的头孢哌酮/舒巴坦、哌拉西林/他唑巴坦对纹带棒杆菌有较高的MIC值。结论纹带棒杆菌在年龄大、免疫力低下人群中分离率高,呼吸机的使用与其感染密切相关;纹带棒杆菌对大多数抗菌药物耐药,属多药耐药菌株,亚胺培南、万古霉素、利福平为临床首选用药。

OBJECTIVE To analyze the results of antimicrobial susceptibility for clinically isolated Corynebacterzurn striatum strains and investigate the distribution of minimal inhibitory concentration （MIC） of the antibiotics commonly used in clinic against C. striatum. METHODS C. striatum was identified with API Coryne System （bioMerieux, France）. Antimicrobial susceptibility test was conducted by agar dilution method. RESULTS MIC90 of imipenem, vancomycin and rifampin against C. striatum was 8, 0. 5 and 2 /μg/ml, and that of amikacin, gentamicin, tobramycin, and minocycline was 8 16μg/ml, but MICg0 of the other antibiotics was 32 -256 μg/ml. The main source of 32 isolates was from bronchofihroseopic secretion. CONCLUSIONS The activity of vancomycin, rifampin and imipenem against C. striatum shows stable susceptibility, but of amikacin, gentamicin, tobramycin and minocycline shows inferiority. However, the susceptibility to other antibiotics is low. So vaneomycin, rifampin and imipenem are the optimal antibiotics to treat the infections caused by C. striatum.