医院感染人苍白杆菌的临床特征与耐药性研究

Study of clinical features and drug resistance of hospital infection caused by Ochrobactrum anthropi

目的探讨医院感染人苍白杆菌的临床特征与耐药性,为临床抗感染治疗提供依据。方法对2008年1月-2017年9月从各临床科室送检的各类标本中分离到的69株人苍白杆菌相关资料进行统计分析。结果 69例人苍白杆菌感染者临床表现无特异,细菌感染性指标显著升高,侵入性诊疗和机体免疫力下降是主要的危险因素;主要集中在感染科和ICU,分别占30.5%和24.6%;标本分布上主要来自血液和导管,分别占62.3%和21.7%;人苍白杆菌对单环β-内酰胺类、含酶抑制剂复合制剂、一代~三代头孢类、青霉素类抗菌药物均保持较高的耐药性,耐药率均高于90.0%,对喹诺酮类、四代头孢类、氨基糖苷类、四环素类和碳青酶烯类抗菌药物敏感性较好,耐药率均低于10.0%。结论侵入性操作诊疗是引起医院感染人苍白杆菌的主要危险因素,该菌主要引起血流感染,人苍白杆菌对β-内酰胺类抗菌药物高度耐药,治疗首选四代头孢类和碳青酶烯类抗菌药物。

Objective To explore the clinical characteristics and drug resistance of hospital infection caused by Ochrobactrum anthropi,so as to provide basis for the clinical anti-infection treatment. Methods The data of 69 strains of Ochrobactrum anthropi isolated from the collected samples in each clinical department during January 2008-September 2017 was conducted for statistical analysis. Results 69 cases of Ochrobactrum anthropi infection in patients showed no specific clinical manifestations,but bacterial infection index significantly increased. Invasive treatment and immunity decrease were the main risk factors;the infections mainly concentrated in the Department of Infectious Diseases and ICU,accounting for 30. 5% and 24. 6% respectively; specimens were mainly from blood and catheter,accounting for 62. 3% and 21. 7% respectively; Ochrobactrum anthropi was high resistant to single-loop β-lactam,composite preparation containing enzyme inhibitor,one to three generations of cephalosporins,penicillins antimicrobial agents,with the resistance rates higher than 90. 0%,and it was sensitive to quinolones,the fourth generation of cephalosporins,aminoglycosides,tetracycline and carbapenem antibacterial drugs,with the resistance rates less than 10. 0%. Conclusion Invasive diagnosis and treatment is the main risk factor of hospital infection caused by Ochrobactrum anthropi,which can cause bloodstream infection. Ochrobactrum anthropi is highly resistant to β-lactam antibiotics,so the fourth generation of cephalosporins and carbapenem antibiotics were primary choices in the treatment of Ochrobactrum anthropi infection.