某三级综合医院2020年—2021年嗜麦芽窄食单胞菌的临床检出情况及其耐药趋势分析

Analysis of Clinical Detection and Drug Resistance Trend of Stenotrophomonas maltophilia in a Tertiary General Hospital from 2020 to 2021

目的:分析医院嗜麦芽窄食单胞菌(Stenotrophomonas maltophilia,SM)的临床检出情况及其耐药情况变化趋势,为临床SM感染患者的救治提供参考。方法:选取2020年1月—2021年12月玉林市妇幼保健院临床各科室送检标本中检出的26 605株病原菌作为研究资料,统计和分析其间各季度SM的检出情况,以及SM对4种常用抗菌药物的耐药趋势变化情况。结果:2020年—2021年,医院临床检出的26 605株病原菌中,SM共有779株,检出率为2.93%;其间,2020年第1~3季度SM的检出率相对较低(<2.00%),而2020年第4季度后SM的检出率相对较高(>3.00%);药敏监测数据显示,SM对头孢他啶、左氧氟沙星、复方磺胺甲噁唑和米诺环素的总耐药率均较低(<20.00%),并且尽管SM对4种抗菌药物的耐药率有所波动,但耐药率始终小于30.00%,其中对左氧氟沙星、复方磺胺甲噁唑和米诺环素的耐药率更是始终小于15.00%。结论:2020年—2021年医院SM的检出率保持在较低水平,且其对头孢他啶、左氧氟沙星、复方磺胺甲噁唑和米诺环素的耐药率较低,临床在救治SM感染患者时可视情况选用,但SM作为国内常见耐药菌,临床应予以重视,定期开展情况监测。

Objective: To analyze the clinical detection and drug resistance trend of Stenotrophomonas maltophilia(SM) in the hospital, so as to provide reference for the treatment of clinical SM infection. Methods: A total of 26 605 strains of pathogenic bacteria detected in specimens sent by clinical departments of the hospital from January 2020 to December 2021 were selected as the research data to conduct statistics and analysis of the detection of SM in each quarter and the trend change of SM resistance to 4 common antibacterial drugs. Results: Among the 26 605 strains of pathogenic bacteria clinically detected in the hospital from 2020 to 2021, there were 779 strains(2.93%) of SM in total.The detection rate of SM from the first to third quarters of 2020 was low(less than 2.00%), while the detection rate of SM after the fourth quarter of 2020 was relatively high(greater than 3.00%). The drug susceptibility monitoring data showed that the total resistance rates of SM to ceftazidime, levofloxacin, compound sulfamethoxazole and minocycline were low(less than 20.00%). Although the resistance rates of SM to four antibacterial drugs fluctuated, they were always less than 30.00%, and the resistance rates of SM to levofloxacin, compound sulfamethoxazole and minocycline were always less than 15.00%. Conclusion: From 2020 to 2021, the detection rate of SM in the hospital remains at a low level,and its resistance rates to ceftazidime, levofloxacin, compound sulfamethoxazole and minocycline are low. It can be used as appropriate for the clinical treatment of patients with SM infection, but clinically attention should be paid to SM, a common drug-resistant bacterium in China, and the regular monitoring should be performed.