斯氏普罗威登菌医院感染状况及耐药性分析

Drug resistance and distribution of clinical Providencia stuartii isolates

目的：探讨斯氏普罗威登菌的医院感染状态及耐药特点，为临床治疗提供帮助。方法回顾性分析76例感染病例的标本来源、科室分布及抗生素药敏情况。结果76例标本主要来源于痰液（71.1％）、伤口分泌物（10．5％）和血液（6．6％）；感染科室主要为重症监护室（40．8％）、呼吸内科（9．2％）和普通外科（7．9％）；该菌耐药情况较严重，多重耐药（MDR）株占65．8％，泛耐药（PDR）株占26．3％，泛耐药株感染患者病死率（45．0％）显著高于非泛耐药患者（5．8％），耐药率较低的抗生素分别是亚胺培南、氟喹诺酮类和阿米卡星等，亚胺培南耐药率最低（31．5％）。结论斯氏普罗威登菌多重耐药现象严重，治疗首选亚胺培南，次选氟喹诺酮类或氨基糖苷类抗生素，对该菌引起的医院感染应加强感染监控。

Objective To study the distribution and drug resistance of clinical Providencia stuartii isolates and provide the basis data for clinical therapy.Methods A data analysis for the specimen source,the distribution of departments with infection and the antibiotic susceptibility results to 76 isolates was conducted in retrospectively. Results Among 76 strains were mainly from sputum （71.1%）,wound secretions （10.5%） and blood （6.6%）;the proportion of these strains from ICU was 40.8%,from respiratory department was 9.2%and from general surgery was 7.9%;The bacteria＇s drug resistance was more serious,multi drug resistant （MDR） strains accounted for 65.8%,pan drug resistant （ PDR） strains accounted for 26.3%,the mortality of patients with PDR strains infection was 45.0%,which was higher than 5.8%of no PDR strains infection.A low resistance rate of antibiotics were imipenem,fluoro-quinolones andamikacin,et al,and the rate of imipenem resistant was lowest（31.5%）.Conclusion The multidrug resistance phenomenon of Providencia stuartii is serious, the first choice for the treatment is imipenem, the second choice was fluoroquinolones or amino glycopeptides antibiotics,the hospital infection caused by the bacterium infection in monitoring should be strengthened.