脑膜炎败血黄杆菌致恶性肿瘤患者下呼吸道感染的临床分析

Clinical analysis on lower respiratory tract infection caused by Flavobacterium meningosepticum in malignant tumor patients

目的探讨脑膜炎败血黄杆菌致恶性肿瘤患者下呼吸道感染的临床耐药特征,为临床合理使用抗菌药物提供依据。方法收集恶性肿瘤患者下呼吸道标本,经BD Phoenix100全自动微生物鉴定仪鉴定为脑膜炎败血黄杆菌,采用K-B法进行药敏试验,按CLSI 2012标准判定药敏结果,用WHONET 5.6软件分析数据。结果药敏试验表明46株脑膜炎败血黄杆菌对多种抗生素耐药,对哌拉西林/他唑巴坦、头孢哌酮/舒巴坦、环丙沙星、左氧氟沙星和复方新诺明的耐药率较低,分别为15.22%、23.91%、26.09%、30.43%和50.00%,其余抗菌药物的耐药率均超过90.00%。结论从恶性肿瘤患者下呼吸道中分离出的脑膜炎败血黄杆菌多重耐药率高,应引起临床重视,并依据药敏试验结果合理选用抗生素。

Objective To investigate the clinical characteristics of drug resistance of lower respiratory tract infection caused by Flavobacterium meningosepticum in patients with malignant tumor,and provide basis for clinical rational use of antimicrobial agents. Methods The specimens from lower respiratory tracts of patients with malignant tumors were collected. BD Phoenix100 automatic microorganism identification instrument was used to identify Flavobacterium meningosepticum. K-B method was used for drug susceptibility testing,and the results were determined according to CLSI 2012 standard. WHONET 5. 6 software was used to analyze the data. Results 46 strains of Flavobacterium meningosepticum were identified,which were resistant to many antibiotics. The resistance rates to piperacillin /tazobactam,Cefoperazone /Shubatan, ciprofloxacin, levofloxacin and cotrimoxazole were lower at15. 22%,23. 91%,26. 09%,30. 43% and 50. 00% respectively,while that to other antimicrobial agents was over 90%. Conclusion Flavobacterium meningosepticum isolated from lower respiratory tracts of patients with malignant tumor has high multidrug resistance. Clinical use of antibiotics should be based on the results of drug sensitivity test.