医院获得性嗜麦芽窄食单胞菌下呼吸道感染或定植临床分析

Clinical analysis of nosocomial infection or colonization of hospital-acquired stenotrophomonas maltophilia

目的探讨医院获得性嗜麦芽窄食单胞菌感染或定植的临床特点及药敏情况。方法回顾性的分析2010年1月至2015年12月期间102例标本培养嗜麦芽窄食单胞菌阳性病历临床和检验资料。结果嗜麦芽窄食单胞菌培养阳性病例下呼吸道标本占94.1%,其中定植菌占70.5%;ICU病例占80.3%;有侵袭性操作史占96.0%;使用过广谱抗菌药物占100%,其中碳青霉烯类药物病例占59.8%。嗜麦芽窄食单胞菌对多种抗菌药物耐药,庆大霉素、妥布霉素、丁胺卡钠、头胞吡肟、头胞他啶、头胞曲松、亚胺培南西司他丁钠、氨曲南、氧哌嗪青霉素耐药率分别为91.2%、88.0%、79.4%、79.5%、54.5%、92.2%、99.0%、96.1%、73.0%;敏感药物为复方磺胺甲恶唑、替卡西林+克拉维酸钾,敏感率分别为83.3%、68.6%。结论嗜麦芽窄食单胞菌培养阳性病例以存在于下呼吸道的定植菌为多。有效治疗嗜麦芽窄食单胞菌药物为复方磺胺甲恶唑、替卡西林联用克拉维酸钾。

Objective To explore the clinical feature and sensitivity of antibiotics drugs of hospital-acquiredstenotrophomonas maltophilia nosocomial infection or colonization. Methods The clinical and laboratory data of 102 cases with hospital-acquired stenotrophomonas maltophilia nosocomial infection or colonization during January 2010 to December 2015 were analyzed retrospectively. Results The proportion of lower respiratory tract was 94. 1% in hospital- acquired stenotrophomonas maltophilia, including colonized bacteria 70. 5%. The proportion of intensive care unit was 80. 3% ,the proportion of invasive operation cases was 96. 0% ,the proportion of broad spectrum antibiotics was 100% , including caropenems 59. 8%. Stenotrophomonas maltophilia are resistant to multiple antimicrobial drugs. The resistance rate of stenotrophomonas maltophilia to gentamicin, tobramycin, amikacin, cefepime, ceftazidine, ceftriuxone, imipenem, aztronan,piperacilin were 91.2% ,88. 0% ,79.4% ,79. 5% ,54. 5% ,92.2% ,99. 0% ,96. 1% ,73. 0% respectively, the trimethoprim-sulfamethoxazole,ticarcillin/clavulanate were sensitivity in drug, and the rate of sensitivity were 83. 3% and 68.6% respectively. Conclusion Most cases of hospital-acquired stenotrophomonas maltophilia are lower respiratory tract and colonization. Trimethoprim-sulfamethoxazole and ticarcillin/clavulanate are the effective antibiotics for stenotrophomonas maltophilia infection.