纹带棒杆菌在临床标本中的分布及耐药性调查

Distribution and Drug Resistance of Corynebacterium striatum in Clinical Specimens

目的了解医院临床标本中纹带棒杆菌的分布及耐药状况。方法将分离菌株经革兰染色后,做触酶、CAMP、O129敏感性、亲脂性等试验,用API-Coryen鉴定试条进行鉴定,再结合形态学及培养等特征进行综合分析;采用纸片扩散法(K-B法)进行药敏试验。结果158株纹带棒杆菌中,经API-Coryen试条鉴定的生物编码共分为8个生物型,其中编码为3100105的菌株有143株,占90.5%;纹带棒杆菌的检出以下呼吸道标本的检出率最高,占91.8%;以14种抗菌药物进行敏感性检测结果显示,主要耐药模式菌有92株,占58.2%。结论纹带棒杆菌的异位定植或感染是多种原因造成的,包括年龄因素、不合理用药、以及免疫力降低等因素;纹带棒杆菌对多种抗菌药物的敏感性降低,多药耐药菌株在增加;在医院存在纹带棒杆菌院内传播的趋势,应采取相应措施防止暴发流行。

OBJECTIVE To investigate the distribution and drug resistance of Corynebacteriurn striatum in the clinical specimens from our hospital. METHODS After Gram staining, a series of tests were performed on the isolated C. striatum, such as catalase test, CAMP test, sensitivity test of O129, the lipophilic test, and so on. The isolates were identified by API-Coryen system and a comprehensive analysis was done in the light of morphological characteristics and training process. The susceptibility to antimicrobials was tested by Kirby-Bauer disk diffusion method. RESULTS Of 158 isolates of C. striaturn, 8 coded biotypes were identified by API-Coryen tests, and 143 isolates were coded as 3100105 （90. 5% of all isolates）. Drug test showed that 92 isolates （accounted for 58.2%） of C. striatum were sensitive to 14 kinds of antimicrobial agents. The detection frequency of C. striaturn in lower respiratory tract infections was 91. 8%, the highest one in all clinical samples. CONCLUSIONS The ectopic colonization or infection of C. striaturn is caused by a variety of reasons, including age, drug abuse as well as factors such as reduced immunity. It concludes that the sensitivity of C. striatum to many antimicrobial agents is in decline and more and more multi-resistant strains are in appearance. The trend of nosocomial spread of the C. striatum exists in our hospital and we should take appropriate measures to prevent the outbreak.