198例医院感染嗜麦芽寡养单胞菌的分析

198 cases of nosocomial Stenotrophomonas maltophilia infection

目的探讨住院患者感染嗜麦芽寡养单胞菌的临床特点及对抗菌药物的敏感性。方法对198例感染嗜麦芽寡养单胞菌的住院患者进行临床分析;菌株鉴定采用法国生物梅里埃公司ATB Expression半自动鉴定仪和ATB 32GN鉴定板条;采用K-B法及E试验条进行药敏试验。结果临床送检各类标本嗜麦芽寡养单胞菌检出以痰标本检出最多,占所有标本的89.38%;该菌在ICU、呼吸内科、心脑血管科、内分泌科等科室检出最高,构成比依次为33.33%、22.73%、15.15%和9.09%等;年龄>60岁老年人感染该菌占87.37%;该菌对CLSI推荐的5种抗菌药物米诺环素、左氧氟沙星、磺胺甲噁唑/甲氧苄啶、头孢他啶、替卡西林/克拉维酸的敏感率依次为98.99%、79.29%、75.25%、53.03%、46.46%。结论高龄、应用多种抗菌药物、严重基础疾病等是该菌感染的危险因素;该菌对多种常用抗菌药物耐药,对米诺环素、左氧氟沙星、磺胺甲噁唑/甲氧苄啶等药物的敏感率较高。

OBJECTIVE To investigate the clinical characteristics of infection caused by Stenotrophomonas maltophilia and analyze the antibiotic sensitivity of S.maltophilia strains.METHODS The clinical data of 198 cases of infection by S.maltophilia were reviewed retrospectively.ATB Expression system and ATB 32GN slip produced by bioMerieux were used to identify the strains.Drug sensitivity testing was performed by K-B methods and E test.RESULTS In all samples,most of the S.maltophilia strain were isolated from sputum（89.38%）.The highest isolating rates occurred in the intensive care unit（ICU）,accounted for 33.33%,The following was the pneumology department（22.73%）,the cardiovascular diseases department（15.15%） and the orthopedic department（9.09%）etc.The patients over 60 ages taken 87.37%.The ranking of drug sensitivity rates from high to low were： mynocycline（98.99%）,levofloxacin（79.29%）,sulfamethoxazole/trimethoprim（75.25%）,ceftazidime（53.03%）,ticarcillin/clavulanate（46.46%）.CONCLUSIONS The old age,many kinds of antibiotics used,serious underlying diseases are the main risk factors of infection caused by S.maltophilia.S.maltophilia is highly sensitive to mynocycline,levofloxacin and sulfamethoxazole/trimethoprim.