116例人苍白杆菌的耐药率及临床危险因素分析

The analysis of resistance rate and risk factors of 116 cases of Ochrobactrum anthropi

目的探讨人苍白杆菌血流感染的临床特点、危险因素分布及耐药特点,为有效预防和治疗该菌血流感染提供科学依据。方法回顾性统计分析2012年1月至2014年12月广州医学院第三附属医院北院收治的116例血液细菌培养为人苍白杆菌感染的临床和检验资料。结果本研究血流感染人苍白杆菌病例中,性别分布为：男性占52.59%（61/116）,女性占47.41%（55/116）;年龄分布为：6岁以下47.41%（55/116）,50岁以上22.41%（26/116）,19~49岁17.24%（20/116）,6~18岁12.93%（15/116）;科室分布为：儿科占45.69%（53/116）,重症监护病房（ICU）占28.45%（33/116）,移植科占9.48%（11/116）,肾内科占6.03%（7/116）,泌尿外科占3.45%（4/116）,神经内科占0.86%（1/116）。人苍白杆菌对青霉素和第1、2、3代头孢菌素类、氨曲南耐药性较高,对4代头孢菌素头孢吡肟的敏感性较高,对亚胺培南、环丙沙星100.0%敏感。结论人苍白杆菌对大多数β-内酰胺类抗菌药物耐药率较高,治疗应首选喹诺酮类、碳青霉烯类等抗菌药物。预防该菌的医院血流感染,应尽量减少不必要的侵入性操作,加强抗菌药物的合理规范使用。

Objective To investigate the clinical characters,distribution of risk factors and drug resistance of blood infection with Ochrobactrum anthropi,and to provide the clinical evidence for the correct treatment.Methods Infection clinical and test datas were collected from 116 cases of blood culture Ochrobactrum anthropi in the Third Affiliated Hospital of Guangzhou Medical College from January 2012 to December 2014.The datas were reviewed and analyzed.Results The sex distribution：in the male,which accounted for 52.59%（61/116）.the female accounted for 47.41%（55/116）;The age distribution of blood infection of Ochrobactrum anthropi showed as following：the children under 6accounted for 47.41%（55/116）.The elder people over 50 accounted for22.41%（26/116）,19-49 years old accounted for 17.24%（20/116）,6-18 years old accounted for 12.93%（15/116）;The department distribution of blood infection of Ochrobactrum anthropi showed as following：in the pediatrics,which accounted for 45.69%（53/116）and the intensive care unit（ICU）accounted for 28.45%（33/116）,the transplant department accounted for 9.48%（11/116）,the renal department of internal medicine accounted for 6.03%（7/116）,the urology surgery accounted for 3.45%（4/116）,the internal medicine-neurology accounted for 0.86%（1/116）.Ochrobactrum anthropi was resistant to penicillin the first,second,third generation cephalosporins and aztreonam,but sensitive to the fourth generation cephalosporins cefepime,imipenem and ciprofloxacin.Conclusion Ochrobactrum anthropi has a high antibiotic resistance toβ-lactam antibiotics,the most effective antimicrobial agents for treating are quinolones and carbapenems.To prevent the bacteria nosocomial blood infections,unnecessary invasive procedures should be minimized,strengthening the rational and specification use of antimicrobial drugs is necessary.