2016—2021年河北省血培养嗜麦芽窄食单胞菌分离株的临床分布及耐药性变迁

Clinical distribution and antimicrobial resistance profiles of Stenotrophomonas maltophilia strains isolated from blood specimen in Hebei Province from 2016 to 2021

目的了解河北省血标本分离嗜麦芽窄食单胞菌的临床分布及耐药性变迁,为临床治疗及合理应用抗生素提供依据。方法收集2016年1月—2021年12月河北省血标本分离嗜麦芽窄食单胞菌数据,采用WHONET 5.6和SPSS 24.0软件对细菌分布及耐药性进行分析。结果河北省2016—2021年血标本分离嗜麦芽窄食单胞菌471株,主要来自老年人(34.4%)、中年人(23.6%)和儿童(21.9%),其中男性分离292株,女性分离179株;重症医学科、内科和儿科为最常见的分离科室,分别占27.8%、25.7%和24.2%。2016—2021年该菌对米诺环素、左氧氟沙星、甲氧苄啶-磺胺甲唑、氯霉素、替卡西林-克拉维酸和头孢他啶的耐药率保持稳定,六年平均耐药率分别为2.3%、7.6%、9.8%、15.8%、31.4%和37.5%;在不同科室间该菌对甲氧苄啶-磺胺甲唑和氯霉素的耐药率差异存在统计学意义(均P<0.05),外科分离菌株对甲氧苄啶-磺胺甲唑耐药率高于其他科室;在不同年龄组间该菌对左氧氟沙星、氯霉素、替卡西林-克拉维酸和头孢他啶的耐药率差异存在统计学意义(均P<0.05)。结论2016—2021年河北省血标本分离嗜麦芽窄食单胞菌主要来自重症医学科,以中老年人群为主。六年间,该菌对常用抗菌药物的耐药率保持稳定,对部分抗菌药物的耐药率在不同科室和年龄组间存在差异。临床可根据药敏结果、患者科室和年龄合理选择抗菌药物。

Objective To understand the clinical distribution and antimicrobial resistance profiles of Stenotrophomonas maltophilia strains isolated from blood specimen in Hebei Province for improving clinical treatment and rational use of antibiotics.Methods The clinical data of bloodstream isolates of S.maltophilia collected from Hebei Antibacterial Resistance Investigation Net from January 2016 to December 2021 were reviewed.The data were analyzed with WHONET 5.6 and SPSS 24.0 software to clarify the distribution and resistance profiles of these strains.Results From 2016 to 2021,a total of 471 strains of S.maltophilia were identified from blood specimen in Hebei Province.These strains were mainly isolated from the elderly(34.4%),middle-aged(23.6%)and children(21.9%).Overall,292 of these strains were isolated from males and 179 from females.These S.maltophilia strains were mainly isolated from intensive care unit(27.8%),internal medicine(25.7%)and pediatrics(24.2%).From 2016 to 2021,the resistance rate of S.maltophilia isolates to minocycline,levofloxacin,trimethoprim-sulfamethoxazole,chloramphenicol,ticarcillin-clavulanic acid and ceftazidime remained stable.The 6-year average resistance rate to the six antimicrobial agents was 2.3%,7.6%,9.8%,15.8%,31.4%and 37.5%,respectively.The resistance rate of the bacteria to trimethoprim-sulfamethoxazole and chloramphenicol varied with clinical settings(P<0.05).The strains isolated from surgery showed higher resistance rate to trimethoprim-sulfamethoxazole than the strains isolated from other departments.The strains isolated from different age groups showed significantly different resistance rates to levofloxacin,chloramphenicol,ticarcillin-clavulanic acid,and ceftazidime(P<0.05).Conclusions Department of Intensive Care Medicine is the most common clinical setting for bloodstream isolates of S.maltophilia in Hebei Province from 2016 to 2021.The middle-aged and elderly people were the main population for bloodstream isolates of S.maltophilia.The resistance rate of S.maltophilia isolates to commonly used antibiotics remained stable in the 6-year period(2016-2021).The resistance rate of S.maltophilia strains varied with different clinical settings and different age groups.Clinicians can prescribe antimicrobial therapy reasonably based on the results of antimicrobial susceptibility testing,clinical setting,and patient age.