洋葱伯克霍尔德菌临床分析及耐药分析

Clinical analysis and drug resistance analysis of burkholderia cepacia

目的：探讨洋葱伯克霍尔德菌感染的临床分布特点及其耐药情况。方法对本院2010～2012年临床分离的103株洋葱伯克霍尔德菌，采用Mcroscan WalkAway 96SI全自动细菌分析仪进行鉴定和药敏试验，对菌株的样本来源、病区分布以及对常用抗生素的耐药率进行统计分析。结果洋葱伯克霍尔德菌检出株数逐年增长；洋葱伯克霍尔德菌样本来源主要为痰液（82.5%），其次为血液（8.7%），并且感染患者多为中老年男性；ICU病房的洋葱伯克霍尔德菌分离率最高（77.7%）；洋葱伯克霍尔德菌对于常用抗菌药物有严重的多重耐药性，且其耐药性有逐年上升的趋势。洋葱伯克霍尔德菌对米诺环素和复方新诺明较为敏感，对氨基糖甙类抗生素呈现出100%的耐药性，对亚胺培南、三代头孢、特治星与喹诺酮类抗生素也呈现高度耐药性。结论洋葱伯克霍尔德菌的临床检出率呈逐年增长趋势，并且多重耐药严重，应加强监测，合理选用抗菌药物，米诺环素和复方新诺明可作为经验性治疗洋葱伯克霍尔德菌感染的首选药物。

Objective To explore the clinical distribution feature and drug resistance of Burkholderia cepacia. Methods A total of 103 Burkholderia cepacia stralns were isolated from our hospital from 2010 to 2012.Bacterial identification and antibiotic susceptibility testing were carried out using Mcroscan WalkAway 96SI automatic bacteria analyzer.And the sample source,the clinical distribution and the drug resistance rate to common antibiotics of Burkholderia cepacia were analyzed. Results Burkholderia cepacia stralns were growing year by year;Sputum was the maln source of Burkholderia cepacia（82.5%）,followed by blood（8.7%）,and most of infected persons were male;Burkholderia cepacia showed severe multidrug resistance to multiple antibiotics,and the drug resistance had a tendency to rise year by year.Burkholderia cepacia was very sensitive to Minocycline and Bactrim,the drug resistance rate of Burkholderia cepacia to aminoglycosides antibiotics was 100%,and Burkholderia cepacia also showed high drug resistance rate to Imipenem,the third generation cephalosporin,Tazocin and Quinolone antibiotics. Conclusion The isolation rate of Burkholderia cepacia is growing year by year.Burkholderia cepacia is very resistant to multiple antibiotics.The observation should be enhanced,and the selection of antibiotics should be more rational. Minocycline and Bactrim can be the priority drugs for the treantmen of infection of Burkholderia cepacia in the clinical experience.