唐菖蒲伯克霍尔德菌血流感染的诊断与治疗

Laboratory diagnosis and treatment of blood infections caused by Burkholderia gladioli

目的探讨唐菖蒲伯克霍尔德菌（Burkholderia gladioli）血流感染的试验诊断和临床治疗方法,以提高临床诊治水平。方法对医院2013年1月-2014年12月104例B.gladioli血流感染患者进行回顾性分析;药敏试验采用纸片扩散法进行,采用WHONEN5.6软件进行数据统计分析。结果 B.gladioli生化表型结果不活跃,阳性期待值指标为亮氨酸（A-LLEUH）、黏杆菌素（C-CLST）、苯丙氨酸（A-LPHET）、色氨酸（A-LTRY）、多黏菌素B（C-PXB）,阳性符合率100.0%;治愈101例治愈率为97.1%,自动出院2例占1.9%,死亡1例病死率为1.0%;对哌拉西林/他唑巴坦等14种抗菌药物呈低耐药性,耐药率在0~32.5%。结论手工鉴定方法很难做出正确的细菌鉴定结果;Phoenixtm100全自动微生物分析系统有助于实验室细菌鉴定程序的标准化,哌拉西林/他唑巴坦可作为B.gladioli血流感染治疗的经验性首选药物。

OBJECTIVE To discuss laboratory diagnosis and treatment of blood infections caused by Burkholderia gladioli so as to improve the diagnosis level in clinical practices.METHODS Retrospective analysis of 104 patients who suffered from blood infection caused by B.gladioli from Jan.2013 to Dec.2014 in our hospital was conducted.RESULTS The biochemical phenotypes of B.gladioli were inactive,and the positive expectations of biochemical phenotypes were A-LLEUH,C-CLST,A-LPHET,A-LTRY and C-PXB.The positive coincidence rate was100.0%.Totally 101 cases were cured（97.1%）,2cases（1.9%）were auto-discharged,and 1case（1.0%）died;B.gladioli showed low drug resistance（0-32.5%）to 14 kinds of antibiotics such as Piperacillin/tazobactam.CONCLUSIONIt′s difficult to make right identification results by manual identification methods.Phoenixtm100 automatic bacteria identification system helps to standardize laboratory bacteria identification procedures.Piperacillin/tazobactam could be the first choice drugs in treating blood infection of B.gladioli.