嗜麦芽窄食单胞菌肺部感染54例临床分析

Pulmonary infection caused by xanthomonas maltophilia:clinical analysis of 54 cases

目的 探讨嗜麦芽窄食单胞菌肺部感染的临床特点 ,以防延误诊治。方法 对 5 4例并发嗜麦芽窄食单胞菌肺部感染患者的临床资料进行回顾性分析。结果 嗜麦芽窄食单胞菌是一种条件致病菌 ,通常合并基础病 (88.9% ) ,有机械辅助通气 (14 .8% )、长期使用抗生素 (90 .7% )及糖皮质激素史 (5 3.7% )。临床表现为咳嗽 4 8例 (88.9% ) ,咯痰 5 1例 (94 .4 % ) ,发热 4 9例 (90 .7% )。胸部X线 4 5例 (83.7% )表现下肺斑片、片絮状阴影或肺纹理粗乱。药敏检测结果显示该菌具有广泛耐药性 ,仅对替卡西林 /可拉维酸钾、复方磺胺甲恶唑、环丙沙星等敏感。结论 嗜麦芽窄食单胞菌肺部感染临床表现不具有特征性 ,易造成误诊或漏诊 ;诊断与治疗主要依据痰细菌培养和药物监测结果。

Objective To analyze the clinical characteritics of pulmonary infection caused by xanthomonas maltophilia (XM) to avoid misdiagnosis and incorrect treatment.Methods 54 cases of lung infection by XM were retrospectively analyzed.Results Pulmonary infection caused by XM was combined with various underlying diseases(88.9%),especially with the immuno compromised diseases 90.7% of the cases were given broad spectrum antibiotics and 53.7% were given steroid.Clinical manifestations included cough (48 cases 88.9%) expectoration (51 cases 94.4%) and fever (49 cases 90.7%).Chest X ray realed infiltration in low lobes of lungs.The drug sensitivity test in vitro showed these strains were multi resistant to commonly used antibiotics.Conclusions Pulmonary infection by XM has no clinical characteristics.It is easily misdiagnosed.The diagnosis and treatment depend on the results of microbial culture and the microbial drug sensitivity test.