ICU患者医院获得性感染洋葱伯克霍尔德菌的临床特征及耐药性分析

Clinical characteristics and drug resistance analysis in ICU patients with hospital-acquired infections of Burkholderia cepacia

目的分析本院重症监护病房(ICU)患者医院获得性感染洋葱伯克霍尔德菌的临床特点及对常用抗菌药物的耐药性,为临床合理治疗提供依据。方法回顾性分析2012年1月至2013年12月,从本院ICU患者送检的细菌培养标本中分离出32株洋葱伯克霍尔德菌的耐药情况。结果从检测部位分析,主要分布在下呼吸道(62.5%),其次为深静脉导管(12.5%)。药敏试验表明,32株洋葱伯克霍尔德菌对多种抗菌药物存在天然耐药,但对米诺环素、氯霉素、美罗培南、头孢他啶和头孢哌酮/舒巴坦仍较敏感,可作为临床治疗洋葱伯克霍尔德菌感染的首选药物。结论洋葱伯克霍尔德菌在ICU患者中的耐药现象非常严重,对洋葱伯克霍尔德菌多重耐药引起的感染,临床应引起高度关注,及早进行微生物学检测,并根据药敏试验结果合理选用抗菌药物。

Objective To analyze the clinical characteristics and resistance to commonly used antibacterial drugs in the intensive care unit（ICU）patients with hospital-acquired Burkholderia cepacia infection in order to provide the basis for clinical rational treatment.Methods The drug resistance situation in 32 strains of Burkholderia cepacia isolated from the bacterial culture speci-mens submitted by ICU of our hospital from January 2011 to December 2012 was performed the retrospective analysis.Results In the detection sites,the infection was mainly distributed in the lower respiratory tract （62.5%）,followed by deep venous catheter （12.5%）;the drug susceptibility test revealed that 32 strains of Burkholderia cepacia showed the natural resistance to multiple antibacterial drugs,but which were still sensitive to minocycline,chloromycetin,meropenem,ceftazidime,cefoperazone/sulbactam, these drugs could be used as the first choice of drugs for treating Burkholderia cepacia infection.Conclusion The drug resistance phenomenon of Burkholderia cepacia is very serious in the ICU patients.Clinic should pay great concern to the infections caused by multi-drug resistant Burkholderia cepacia ,the microbiological testing should be conducted as early as possible,and the antibacterial drugs should be rationally selected according to the drug susceptibility testing results.