104株嗜麦芽窄食单胞菌的耐药率及其治疗方案分析

Analysis of Antibiotic Resistance Rates and Therapeutic Regimen of 104 Strains of Stenotrophomonas Maltophilia

目的:分析嗜麦芽窄食单胞菌的耐药率及有效的治疗方案。方法:采用WHONET软件对医院2013年—2014年间微生室分离的嗜麦芽窄食单胞菌对抗菌药物的耐药率作了统计,并对其感染病例治疗的有效率作了回顾性分析。结果:2013年—2014年间分离的嗜麦芽窄食单胞菌104株,其中定植菌为26株,致病菌为78株;嗜麦芽窄食单胞菌感染患者78例,其年龄≥60岁占80.76%;并且57.69%患者伴有慢性呼吸道疾病;嗜麦芽窄食单胞菌对左氧氟沙星、复方磺胺甲噁唑和米诺环素的敏感率分别为82.22%、94.74%和100.00%,其对头孢哌酮-舒巴坦的耐药率为36.84%;采用的4种治疗方案分别为β-内酰胺酶抑制剂复合制剂、第3代或第4代头孢菌素、第3代头孢菌素与左氧氟沙星联用、β-内酰胺酶抑制剂复合制剂与阿米卡星联用;治疗的总有效率分别为56.60%、60.00%、58.82%和100.00%。结论:哌拉西林-他唑巴坦、头孢哌酮-舒巴坦单独或哌拉西林-他唑巴坦与阿米卡星联用,可有效治疗嗜麦芽窄食单胞菌导致的感染。

Objective： To analyze the antibiotic resistance rates and therapeutic regimen of 104 strains of Stenotro- phomonas Maltophilia（S.maltophilia）. Methods： The antibiotic resistance of S.maltophilia that was isolated from our hospital during 2013-2014 was analyzed by WHONET software; treatment outcomes for S.maltophilia bacteraernia were evaluated by retrospectively analysis. Results： Total 104 strains of S.maltophilia were isolated from year 2013 to 2014, they were divided into two groups： 26 strains were colonized only and 78 strains were infected by S.maltophilia. 80.76% of patients who were infected S.maltophilia＇, aged ≥60, and 57.69% of infected patients has chronic respiratory disease. About 82.22%, 94.74%, 100.00% and 36.84% of the S.maltophilia isolates had sensitivity rates to levofloxacin, trimethoprim-sulfamethoxazol, minocycline and cefoperazone-sulbactam respectively. The patients who were infected 5＇. maltophilia received four treatment strategies： B-lactam-enzyme inhibitor. They received the third or the fourth genera- tion cephalosporin, the third or the fourth generation cephalosporin combination with levofloxacin and B-lactaln-en- zyme inhibitor combination with amikacin; the clinical effective rate was 56.60%, 60.00%, 58.82% and 100.00%, re- spectively. Conclusion： Piperacillin-tazobactam and cefperazone-sulbactam monotherapies or piperacillin-tazobactam combinantion with amikacin were effective for the treatment orS. maltophilia infections.