洋葱伯克霍尔德菌临床感染特点与耐药现状

Drug Resistance of Burkholderia cepacia:Clinical Characteristics and Current Status

目的了解洋葱伯克霍尔德菌（BCE）临床感染特点和耐药现状。方法对2006-2007年从各类临床标本中分离到的洋葱伯克霍尔德菌株统一用K-B法进行体外药敏试验，并对患者资料进行统计分析。结果分离菌株最多的标本是痰液18株（39．1％）和血液9株（19．6％）；分离菌株最多的病区是ICU28株（60．9％）；药敏试验结果表明，氨苄西林／舒巴坦全部耐药，阿米卡星等3种氨基糖苷类药物以及环丙沙星，哌拉西林和亚胺培南耐药率高达63．0％～84．8％，复方新诺明、头孢他啶、头孢吡肟、哌拉西林／他唑巴坦、头孢哌酮／舒巴坦和美罗培南的耐药率〈40．0％。结论严重的基础性疾病，频繁的侵入性操作，抗菌药物过多、过滥使用均是引起BCE感染的主要原因，BCE感染时抗菌药物可选用美罗培南、复方新诺明、头孢他啶、哌拉西林／他唑巴坦和头孢哌酮／舒巴妇。

OBJECTIVE To study the clinical characteristics and current status of the drug resistance of Burkholde-ria cepacia （BCE）. METHODS Drug sensitivity test was performed on BCE with K-B method isolated from clinic specimen from 2006 to 2007 and the patients＇ data were analyzed. RESULTS The pathogens were mainly isolated from sputum （18 strains, 39.1%） and blood （9 strains, 19.6%）. ICU was the common department （28 strains, 60.9%）; all strains of BCE were resistant to ampicillin/sulbactam. The resistance rate to 3 kinds of aminoglycosides （amikacin etc）, ciprofloxacin, piperacillin and imipenem were 63.0-84.8%. The resistance to sulfamethoxazole compound, ceftazidime, cefepime piperacillin/tazobactam, cefoperazone/sulbactam and meropenem were less than 40.0%. CONCLUSIONS Serious underlying diseases, frequent invasive operation and drug abusement were the main causes of BCE infection. Meropenem, sulfamethoxazole compound, ceftazidime, piperacillin/tazobactam and cefoperazone/sulbactam could be selected to treat BCE infection.