株嗜麦芽窄食单胞菌感染的临床及抗菌药物使用分析.doc

183株嗜麦芽窄食单胞菌感染及抗菌药物使用分析.白求恩国际和平医院 临床药学室，河北 石家庄 050082；2. 白求恩国际和平医院 检验科，河北 石家庄 050082） 目的:分析和总结株嗜麦芽窄食单胞菌感染情况和对抗菌药的耐药情况，为临床预防和治疗该菌引起的感染提供依据。方法:对临床标本中分离的株嗜麦芽窄食单胞菌进行细菌鉴定和药敏试验，复习有关临床资料，分析发病的危险因素。结果:株嗜麦芽窄食单胞菌检出标本以痰为主，占.2%；居检出临床科室前4位的依次为呼吸科（.8%）、科（2.7%）、ICU病房 （1.6%）、肿瘤科 （.9%）；高龄、侵入性诊疗操作、使用广谱抗菌药为嗜麦芽窄食单胞菌感染的危险因素，分别占.0%、.8%、100%；株对常用抗菌素耐药，敏感率超过50%的抗菌药依次为复方磺胺甲唑（.3%）、头孢哌酮钠舒巴坦（.9%）、西林（6.5%）、沙星（.4%）。结论:嗜麦芽窄食单胞菌感染多发生在有各种基础疾病、免疫力低的患者，该菌耐药现象严重，治疗应根据药敏试验结果合理选用抗菌药。 [关键词] 细菌嗜麦芽窄食单胞菌感染Analysis of clinical characteristics and drug sensitivity tests of 183 strains of infection by stenotrophomonas maltophilia Xuehongyuan1，Houtianwen2 （Dep. of Pharmacology；2.Dep. of Clinical Laboratory, Bethune International Peace Hospital, Shijiazhuang 050082, China） [Abstract] Objective:der to provide basis for the prevention and treatment of the infection indused by the bacterium. Methods: 183 strains of Stenotrophomonasmaltophilia from clinical isolates were identified and their susceptibility was tested. Clinical data were reviewed, and risk factors were analysized. Results: Most of 183 strains were isolated from sputum（%）strains were mainly isolated from department of respiratory medicine（%）, ICU（%）, department of （4.7%）, and department of （%）Risk factors was old age, invasive procedures and the use of broad spectrum antibiotics, account for 80.0%, 41.8% and 100%, respectively. The drug sensitivity tests in vitro showed that these strains were resistant to commonly used antibiotics, and drugs whose sensitive rate was over 50% included SMZ-TMP（%）, cefoperazone-sulbactam（%）, cillin-tazobctam（%）, andofloxacin（4%）Conclusion: The infection caused by Stenotrophomonasmaltophilia often occur in patients with severe underlying diseases and low immunity. Stenotrophomonasmaltophilia is resistant to many kinds of antibiotics. Antibiotics should be chosen by drug sensitivity tests. [Key words]　bacteria, stenotrophomonasmaltophilia, infection, antibiotic. 1 引 言 嗜麦芽窄食单胞菌（Stenotrophomonas maltophiliaSMA）是一种在自然界广泛分