脑膜脓毒性金黄杆菌医院感染危险因素及耐药性分析

Nosocomial Infection by Chryseobacterium meningosepticum: Risk Factors and Drug-resistance

目的 探讨脑膜脓毒性金黄杆菌医院感染的危险因素及耐药性。方法 回顾性调查 1999年 1月～ 2 0 0 1年 8月脑膜脓毒性金黄杆菌医院感染 18例 ,对其临床相关资料及体外药敏结果进行分析。结果 88.89%有严重基础疾病 ;同时或先后接受过多种或多次侵入性操作者占 72 .2 2 % ,其中有 6 6 .6 7%患者接受过呼吸道操作 ;住院时间 >30d占 72 .2 2 % ;均使用过二种以上抗生素 ;对亚胺培南、氨曲南、三四代头孢菌素及氨基糖苷类抗生素多重耐药 ,耐药率较低的抗生素是头孢哌酮 /舒巴坦、替卡西林 /克拉维酸 (18.18% )、哌拉西林 /三唑巴坦 (2 5 % )。结论 严重多种基础疾病并多种侵入性操作是主要危险因素 ,其次是病程长和长期广谱抗生素的应用 ,而在各易感因素迭加时 ,易导致该细菌感染的发生 ;尽早进行微生物检查 ,根据药敏结果选择抗生素。

OBJECTIVE To analyse the risk factors of hospital acquired infection by Chryseobacterium meningosepticum and to investigate the antibiotic drug resistance. METHODS Retrospective study of the clinical data of 18 cases with hospital acquired infection by C.meningosepticum, from Jan 1999 to Aug 2001, including relative clinical symptoms and signs, the drug sensitivity results. RESULTS Critical underlying diseases(88.89%), various invasive treatments used(72.22%, including 12 cases with respiratory tract invasive treatment), long term hospitalization (72.22%) and unsuitable application of antibiotics (100%) were the risk factors. The drug sensitivity tests showed that these strains were multi resistant to commonly used antibiotics, such as imipenem, aztreonam, third or fourth generation cephalosporins and aminoglycoside antibiotics, but sensitive to cefoperazone/sulbactam(100%). CONCLUSIONS The main risk factors of hospital acquired infection by C.meningosepticum are critical underlying diseases and various invasive treatments used, the others are long term hospitalization and long term in appropriate use of broad spectrum antibiotics. These strains are developed in patients with multiple risk factors easily. Early appraisement of microorganism, correct and appropriate treatment in accordance with drug sensitivity are the effective measures.