嗜麦芽窄食单胞菌的临床分布及耐药性分析

Clinical distribution and drug resistance analysis of Stenostomonas maltophilia

目的分析嗜麦芽窄食单胞菌临床分布情况及对常用抗菌药物耐药性分析。方法收集2019年1月至2021年12月河北医科大学第二医院住院患者分离的嗜麦芽窄食单胞菌,采用WHONET 5.6软件对嗜麦芽窄食单胞菌的临床科室分布、标本来源及药物敏感性试验开展回顾性研究。结果2019年1月至2021年12月共分离得到嗜麦芽窄食单胞菌共966株,在革兰氏阴性杆菌中的检出率为2.54%,检出率最高科室为小儿内科;临床科室分布中呼吸内科构成比最高(30.85%);感染患者以60岁以上老年患者为主,占57.04%;标本来源以痰标本为主,共分离771株,占79.81%。药敏结果分析显示,嗜麦芽窄食单胞菌对米诺环素、复方新诺明和左氧氟沙星的耐药率较低,耐药率分别为2.60%、10.40%、13.50%;对头孢他啶耐药率较高,耐药率为70.9%。不同标本来源嗜麦芽窄食单胞菌药敏结果显示,灌洗液、尿、血标本中嗜麦芽窄食单胞菌对米诺环素、复方新诺明、左氧氟沙星、头孢他啶的耐药率均高于痰标本。结论嗜麦芽窄食单胞菌主要来自呼吸内科,以痰为主。易感人群为老年人,耐药性高,临床医师应根据药敏结果合理选择抗菌药物,减少耐药菌株的产生及流行。

Objective To analyze the clinical distribution and resistance of Stenotrophomonas maltophilia.Methods Stenotrophomonas maltophilia was isolated from hospitalized patients in the Second Hospital of Hebei Medical University from January 2019 to December 2021,and the clinical distribution,specimen sources,and drug sensitivity tests of stenotrophomonas maltophilia were retrospectively analyzed through WHONET 5.6 system.Results A total of 966 strains of Stenotrophomonas maltophilia were isolated from January 2019 to December 2021,and the detection rate of gram-negative bacilli was 2.54%.The department with the highest detection rate was pediatric internal medicine.The proportion of Stenotrophomonas maltophilia in respiratory department was the highest(30.85%).The majority of patients with Stenotrophomonas maltophilia infection were elderly patients over 60 years old,accounting for 57.04%.A total of 771 strains of Stenotrophomonas maltophilia were isolated from sputum specimens,accounting for 79.81%.The drug susceptibility test results showed that the drug resistance rates of Stenotrophomonas maltophilia to Minocycline,Cotrimoxazole,and Levofloxacin were 2.60%,10.40%and 13.50%,respectively;the drug resistance rate to ceftazidime was 70.9%.The drug susceptibility results of Stenotrophomonas maltophilia from different samples showed that the drug resistance rates of stenotrophomonas maltophilia in lavage fluid,urine and blood samples were higher than those in sputum samples to Minocycline,Cotrimoxazole,Levofloxacin,and Ceftazidime.Conclusion Stenotrophomonas maltophilia mainly came from respiratory department,mainly sputum.The susceptible population is the elderly with high drug resistance.Clinicians should reasonably select antibiotics according to the results of drug sensitivity to reduce the generation and prevalence of drug-resistant strains.