洋葱伯克霍尔德菌致恶性肿瘤患者医院获得性感染的耐药性分析

Drug resistance of Burkholderia cepacia causing hospital acquired infection in malignant tumor patients

目的分析我院恶性肿瘤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2011年1月至2013年12月,从我院恶性肿瘤感染患者送检的细菌培养标本;细菌鉴定用美国BD公司phoenix-100全自动细菌鉴定药敏系统,药敏试验采用纸片法,同时使用WHONET 5.6软件对相关资料进行统计。结果从检测部位分析主要分布在下呼吸道（74.1%）,其次为血液（9.4%）;药敏试验表明139株洋葱伯克霍尔德菌对米诺环素、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,其余15种抗菌药物的耐药率高达30.0%~100%。结论洋葱伯克霍尔德菌在恶性肿瘤患者中的耐药现象非常严重,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 drug resistance of Burkholderia cepacia in malignant tumor patients with hospital acquired infection,and provide basis for clinical treatment. Methods Retrospective analysis was performed on the bacterial specimens from malignant tumor patients with Burkholderia cepacia infection in ouor hospital from January 2011 to December 2013. USA BD PHOENIX-100 automatic bacterial identification and susceptibility system was used for the identification of bacteria,and Whonet 5. 6 software for statistical analysis. Results The infected site was mainly lower respiratory tract（ 74. 1%）,followed by blood（ 9. 4%）.The 139 strains of Burkholderia cepacia was sentisitive to Minocycline,Chloramphenicol,Meropenem,Ceftazidime and Cefoperazone / sulbactam,while resistant to the other 15 antimicrobial agents（ up to 30. 0%- 100%）.Conclusion The drug resistances of Burkholderia cepacia from patients with malignant tumor are very high. Early microbiological tests should be conducted and the rational use of antimicrobial drugs should be based on susceptibility test results.