ICU感染嗜麦芽窄食假单胞菌分布与耐药性分析

Distribution and drug resistance of Stenotrophomonas maltophiliain ICU

目的了解ICU感染嗜麦芽窄食假单胞菌的分布与耐药性,比较本院ICU与非ICU嗜麦芽窄食假单胞菌的耐药性,为临床合理应用抗菌药物提供科学依据。方法对2011年6月-2014年6月临床标本中分离的嗜麦芽窄食假单胞菌120株采用K-B纸片法进行药敏试验,应用SPSS 20.0对数据进行统计分析。结果嗜麦芽窄食假单胞菌主要来源于呼吸道标本(痰),占69.17%。临床分布以ICU多见,占30.00%。在20种抗菌药物中有14种抗菌药物耐药率>50%,仅氧氟沙星、复方磺胺甲唑、米诺环素、左氧氟沙星等有较低耐药率,耐药率分别为0.00%、16.67%、1.67%、9.17%;头孢噻肟、阿莫西林/克拉维酸、亚胺培南、头孢哌酮/舒巴坦、美罗培南等12种抗菌药物ICU与非ICU耐药率分别为100.00%,66.67%;97.22%,75.00%;100.00%,40.48%;97.22%,33.33%;100.00%,79.76%;差异有统计学意义(P<0.05)。结论临床感染嗜麦芽窄食假单胞菌对常用抗菌药物耐药严重,ICU嗜麦芽窄食假单胞菌耐药率明显高于非ICU,临床应高度重视,控制感染。

Objective To investigate the distribution and drug resistance of Stenotrophomonas maltophilia from ICU patients with infections,and provide scientific basis for clinical rational use of antimicrobial agents.Methods One hundred and twenty strains of S.maltophiliaisolated from clinical samples from June2011 to June 2014 were collected,and the drug sensitivity was detected with K-B disk method;the results were analyzed with the SPSS 20.0software.Results Most of the S.maltophiliastrains came from sputum specimens（69.17%）,which distributed mainly in Hepatobiliary Surgery（30.00%）.The resistance rates of S.maltophiliato 14 out of 20 antibacterial drugs were over 50%,while those to ofloxacin（0.00%）,trimethoprim sulfamethoxazole（16.67%）, minocycline（1.67%）and levofloxacin（9.17%） were lower.Cefotaxime,amoxicillin/clavulanic acid,imipenem,Cefoperazone/sulbactam and meropenem 12 kinds of antibacterial drugs in ICU and non-ICU resistance rate was 100.00%,66.67%;97.22%,75.00%,100.00%,40.48%,97.22%,33.33%,100.00%,79.76%;the differences were statistically significant（P〈0.05）.Conclusion The clinical isolates of Stenotrophomonas maltophilia are highly resistant to antibiotics.The resistance rates of the pathogen from ICU are significantly higher than those from non-ICU,Clinical should attach great importance to control infection.