糖尿病合并类鼻疽伯克霍尔德菌感染40例

Feature of 40 diabetes patients complicated with Burkholderia pseudomallei infection and drug resistance.

目的了解糖尿病患者合并类鼻疽伯克霍尔菌感染的特点和耐药性。方法收集2002年01月～2008年12月糖尿病合并类鼻疽伯克霍尔菌感染者40例,采用微量肉汤法对菌株进行药敏试验。结果这些病例以败血症多见占72.5%,其次为肺部感染,肝脓肿,脾脓肿,左腹股沟脓肿和尿路感染。类鼻疽伯克霍尔德菌对亚胺培南和美洛培南100%敏感、对哌拉西林/他唑巴坦82.1%敏感、头孢他啶59.4%敏感及头孢噻肟钠47.3%敏感、复方新诺明42.4%敏感等。结论糖尿病患者合并类鼻疽伯克霍尔德菌感染容易发生败血症,建议亚胺培南和美洛培南作为治疗类鼻疽伯克霍尔德菌感染的首选用药。该菌对多种常用抗生素耐药率较高,应当引起临床医师的高度重视。

Ahn To analyze the characteristics and antibiotics resistance of Burkholderia pseudomallei infecting the patients with diabetes. Methods A total of 40 cases of diabetic patients infected by Burkholderia pseudomallei from January 2002 to December 2008 were analyzed. Susceptibility test was performed by broth mierodilution method. Results Sepsis accounted for 72.5% in these patients,followed by pulmonary infection,liver abscess,splenic abscess,left groin abscess and urinary tract infection. Burkholderia pseudomaUei exhibited high sensitivity to imipenem （100%）,meropene （100%） and peraeillin / tazobactam （82.1%）. The sensitivity rate to ceftazidime, cefotaxime and cotrimoxazole was 59.4%, 47.3% and 42.4% respectively. Conclusion The diabetic patients infected by Burkholderia pseudomallei easily have sepsis. It is suggested that imipenem and mempene are preferred drugs for clinical infection with Burkholderia pseudomallei. The bacteria poses a serious situation of multi-drug resistance which should be attached great importance to clinicians.