嗜麦芽窄食单胞菌感染的临床分布和耐药性分析

Analysis of clinical distribution and drug resistance of Stenotrophomonas maltophilia infection

目的了解医院嗜麦芽窄食单胞菌感染的临床分布及耐药情况,为医院感染控制及临床用药提供指导。方法回顾性分析本院2012年1月-2014年12月1 067株嗜麦芽窄食单胞菌的标本来源、科室分布及药敏结果。结果菌株主要来源于呼吸道标本,占89.69%,其次为分泌物、胆汁,所占比例分别为3.19%、2.91%;菌株临床分布主要为ICU、神经外科病区,所占比例分别为45.92%、16.03%;该菌对米诺环素最敏感,3年耐药率为0.00%～1.42%,对甲氧苄啶-磺胺甲噁唑和左氧氟沙星的耐药率均〈20%,对头孢哌酮/舒巴坦的耐药率为8.16%～8.60%。结论嗜麦芽窄食单胞菌主要分离自ICU及神经外科以痰为主的呼吸道标本。该菌对CLSI推荐的药物耐药率均较低（〈20%）,抗菌活性3年基本保持稳定,应根据药敏结果合理选用抗菌药物进行治疗。

Objective To understand the clinical distribution characters and drug resistance of Stenotrophomonas maltophilia infetion so as to guide the rational usage of clinical drugs and control the infection. Methods From 2012 January to 2014 December,a total of 1 067 strains of Stenotrophomonas maltophilia were retrospectively analyzed of specimen source,distribution of departments and the drug sensitivity results. Results Stenotrophomonas maltophilia isolated from this hospital were mainly respiratory specimens,accounting for 89. 69%,the following were secretion and bile,accounting for 3. 19% and 2. 91%,respectively; the strains were mainly distributed at intensive care unit（ ICU） and department of neurosurgery,accounting for 45. 92% and16. 03%,respectively; the bacteria were most sensitive to minocycline,the resistance rate for 3 years was 0. 00%- 1. 42%;the resistance rate to trimethoprim sulphamethoxazole and trimethoprim and levofloxacin rate was less than 20%,and the resistance rate to cefoperazone / sulbactam was 8. 16%- 8. 60%. Conclusion Stenotrophomonas maltophilia mainly isolated from sputum of ICU and department of neurosurgery and respiratory specimens. The resistance rate of the bacteria were low of the drug which recommended by CLSI（ 20%）; the antibacterial activity were remained stability in three years. According to the results of drug sensitivity,antibiotics should be rationally selected for treatment.