216株金黄杆菌属的医院感染分布及耐药性分析

Distribution and drug resistance of 216 strains of Chryseobacteriumcausing nosocomial infections

目的分析医院216株金黄杆菌属医院感染及其耐药性。方法选取医院2009年1月-2012年2月发生的216例金黄杆菌属医院感染病例为研究对象,采用VITEK-AMS 60全自动微生物分析系统及配套革兰阴性杆菌鉴定卡(GIN)对216例标本进行分析,并用纸片扩散法(K-B法)检测其耐药率。结果 216份金黄杆菌属标本主要来源于ICU、呼吸科、神经外科、儿科及老年病科,分别占33.33%、23.61%、13.89%、12.04%、11.11%;该组216株金黄杆菌属对常用12种抗菌药物药敏试验结果显示,对头孢哌酮/舒巴坦敏感率最高,为99.07%,其次为万古霉素、利福平,敏感率为74.54%、60.65%,而对头孢哌酮、头孢曲松、亚胺培南、美罗培南、左氧氟沙星敏感率较低,耐药率均≥75.00%,分别为79.17%、75.00%、78.24%、89.35%、85.19%。结论金黄杆菌属医院感染多发生于重症医学科、呼吸科以及神经外科等,并对多种抗菌药物耐药;临床治疗应根据药敏试验结果选择较敏感的抗菌药物,头孢哌酮/舒巴坦可作为临床治疗金黄杆菌属细菌感染的首选抗菌药物。

OBJECTIVE To analyze the drug resistance of 216 strains of Chryseobacterium causing nosocomial infections. METHODS From Jan 2009 to Feb 2012, a total of 216 patients with Chryseobacterium infections were selected as the study subjects, the specimens were analyzed by the VITEK-AMS 60 automatic microbial analysis system and supporting gram-negative bacteria identification card （GIN）, and the drug resistance rate was determined by disc diffusion method （K-B method）. RESULTS Most of the 216 strains of Chryseobacterium were isolated from ICU （33.330% ）, respiratory department （23.61% ）, neurosurgery department （13.89 % ）, pediatric department （12. 04%）, and geriatrics department （11. 11%）; the antimicrobial susceptibility testing for 216 strains of Chryseobacterium to 12 commonly used antibiotics showed that the drug susceptibility rate to cefoperazone/sulbactam was the highest （99. 07%）, followed by vaneomyein （74. 54%） and rifampicin （60.65%）, the drug susceptibility rates to cefoperazone, ceftriaxone, imipenem, meropenem and levofloxacin were relatively low, the drug resistance rates were 79. 17%, 75. 00%, 78. 24%, 89. 35%, and 85. 19%, respectively. CONCLUSION The Chryseobacterium infections occur frequently in the ICU, respiratory department and neurosurgery department and are multidrug-resistant; it is necessary to choose the susceptible antibiotics based on the drug susceptibility testing, cefoperazone/sulbactam can be used as the preferred antibiotics for Chryseobacterium infections.