60株嗜麦芽寡养单胞菌的临床分布与耐药性分析

Clinical Distribution and Drug Resistance Analysis of 60 Stenotrophomonas maltophilia Isolates

目的了解临床分离的60株嗜麦芽寡养单胞菌的临床分布与耐药情况,为临床治疗嗜麦芽寡养单胞菌感染提供依据。方法用VITEK-32型微生物鉴定系统GNI+卡对60株嗜麦芽寡养单胞菌进行鉴定,并用K-B法进行20种抗菌药物敏感试验;数据处理应用WHONET5.3软件分析。结果60株嗜麦芽寡养单胞菌在临床标本中分布以痰液为主占63.3%。感染主要发生呼吸科I、CU、老干部科等;嗜麦芽寡养单胞菌对亚胺培南、氨基糖苷类及大部分β-内酰胺类抗菌药物呈高度耐药;对复方新诺明耐药率最低,为16.7%;其次为米诺环素、左氧氟沙星、头孢哌酮/舒巴坦、哌拉西林/他唑巴坦、替卡西林/克拉维酸,耐药率分别为18.3%、20.0%、21.7%、25.0%、30.0%。结论嗜麦芽寡养单胞菌耐药状况十分严重,而且各地区耐药情况差异很大,应建立本地菌株的药谱,并尽早根据药敏情况选择用药。

OBJECTIVE To investigate the clinical distribution and drug resistance status of Stenotrophomonas maltophilia and provide clinical guidance for treatment.METHODS Sixty clinical isolates of S.maltophilia were identified with GNI＋ cards of VITEK-32.Drug sensitivitiy were detected by Kirby-Bauer disc diffusion method.The data were analyzed by WHONET5.3 software.RESULTS Thirty-eight strains were isolated from sputum（63.3%）.Infection caused by S.maltophilia mainly occurred at the departments of respiratory diseases,ICU,old cadre,et al.Sixty isolates of S.maltophilia were highly resistant to imipenem,aminoglycosides and most of β-lactam antibiotic,but showed the lowest resistance rate（16.7%） to SMZ/TMP.Then resistance rate of S.maltophilia to minocycline,levofloxacin,cefoperazone/sulbactam,piperacillin/tazobactam,and ticarcillin/clavulanic acid was 18.3%,20.0%,21.7%,25.0% and 30.0%,respectively.CONCLUSIONS The drug resistance of S.maltophilia is extremely severe.Among different areas of china the drug resistance is obviously different.Treatment based on drug susceptibility test should be adapted as soon as possible.