我院2007年洋葱伯克霍尔德菌的药敏结果和抗菌药物治疗分析.doc

我院2007年洋葱伯克霍尔德菌的药敏结果和抗菌药物治疗分析 姚高琼1夏云2(1.重庆医科大学附属第一医院药剂科临床药学，重庆 400016；2. 重庆医科大学附属第一医院检验科，重庆 400016) [摘要] 目的：监测我院临床分离的洋葱伯克霍德菌的耐药性及分析临床抗菌药物治疗方案，为临床医师和临床药师更好地治疗此菌引起的感染提供依据。方法：　分析我院2007年分离的17株洋葱伯克霍尔德菌的药敏试验结果及临床治疗方案及效果。结果：该菌在我院临床分离细菌的检出率为0.13%。检出标本为各重症监护病房( ICU)病人的痰（15例）、尿液（1例）、导管尖端（1例），培养出细菌的时间最少为入院后3天，最长为入院后112天。药敏试验结果显示体外抗菌药物敏感率分别为哌拉西林/他唑巴坦（88.2％）、头孢他啶（82.4％）、美洛培南（76.5％）、复方新诺明（64.7％），其次为环丙沙星（52.9％）、哌拉西林（52.9％）、头孢吡肟（41.2％）、亚胺培南仅29.4％；对多粘菌素E、氨苄西林/舒巴坦、庆大霉素、阿米卡星、替卡西林/克拉维酸、替卡西林、妥布霉素完全耐药。临床治疗方案根据药敏结果选择抗菌药物治疗有效（复查未检出菌为标准）的有9例，占52.9％。结论：洋葱伯克霍尔德菌是一种重要的院内感染病原菌，该菌具有多重耐药性，治疗上可选用哌拉西林/他唑巴坦、头孢他啶、美洛培南和复方新诺明，而不宜选用亚胺培南、氨基糖苷类及其他β－内酰胺酶类抗菌素。 关键词：洋葱伯克霍尔德菌；抗菌药物；药敏实验；药物治疗 [中图分类号] R969.3 [文献标识码] B [文章编号]W08－020 Susceptibility In vitro and antibacterial therapeutic regimen of Burkholderia cepacia in 2007 in our hospital YAO-gaoqiong 1 xiayun 2(1.Department of Clinical Pharmacy, The First Affiliated Hospital ,Chongqing Medical University ,Chongqing 400016;2. Clinical Laboratory, The First Affiliated Hospital ,Chongqing Medical University ,Chongqing 400016) ABSTRACT OBJECTIVE To discuss how to control such infections caused by Burkholderia cepacia through monitoring the bacterial resistance and analyzeing the antibacterial therapeutic regimen of Burkholderia cepacia .METHODS Results of susceptibilitity test and antibacterial therapeutic regimen to 17 strains of Burkholderia cepacia splited in our hospital were analyzed. RESULTS Isolating rate of Burkholderia cepacia in our hospital was 0.13%. The sorts of specimens were sputum(15cases),urine(1case)and catheter tip(1case) in some intensive care units ( ICU).The least cultivated time was 3rd day after hospital admission ,and the long was d-112 . The susceptibilitive rate to some antibacterial of Burkholderia cepacia in vitro was : piperacillin sodium/tazobactam (88.2%), ceftazidine (82.4%) , meropenem (76.5%), SMZ-TMP (64.7%), ciprofloxacin (52.9%), piperacillin sodium (52.9%), cefepime (41.2%), imipenem (29.4%); and other