嗜麦芽窄食单胞菌感染152例临床分析

发布时间：2018-01-14 14:36

本文关键词：嗜麦芽窄食单胞菌感染152例临床分析　出处：《中国感染与化疗杂志》2016年04期 　论文类型：期刊论文

【摘要】：目的统计分析医院感染嗜麦芽窄食单胞菌的临床资料和药敏试验数据,为临床控制和预防嗜麦芽窄食单胞菌感染提供依据。方法收集泰安市第一人民医院2010年1月-2013年12月嗜麦芽窄食单胞菌感染的临床病例及药敏资料进行统计分析与描述。结果共152例嗜麦芽窄食单胞菌感染患者,感染多发生在入院2周以后,以呼吸系统感染症状表现为主。有基础结构性肺病和恶性肿瘤患者易发生嗜麦芽窄食单胞菌感染,且以肺炎居多。患者感染前使用亚胺培南等碳青霉烯类药物和头孢菌素类广谱抗生素、患有严重的基础疾病、接受各种侵袭性操作、老年、免疫力低下、肿瘤为高频致感染因素。患者主要分布在重症监护病房、呼吸内科、胸外科。药物敏感率从高到低依次为:米诺环素(94.7%),甲氧苄啶-磺胺甲唑(90.1%),左氧氟沙星(86.8%),头孢哌酮-舒巴坦(57.8%),替卡西林-克拉维酸(54.6%),头孢他啶(51.3%)。老年组和成年组分离菌株的药物敏感率和耐药率差异无统计学意义(P0.05)。结论碳青霉烯类药物和头孢菌素类广谱抗生素的广泛应用、侵袭性操作、免疫力下降的患者更易感染嗜麦芽窄食单胞菌。加强患者嗜麦芽窄食单胞菌的检测,依据药敏试验合理使用抗生素,是治疗嗜麦芽窄食单胞菌感染的有效措施。
[Abstract]:Objective to analyze the clinical data and drug sensitivity test data of Nosocomial infection of Stenotrophomonas maltophilia. Methods the clinical cases and drug sensitivity of Stenomonas maltophilia infection from January 2010 to December 2013 in the first people's Hospital of Taian City were collected. Results 152 patients with Stenotrophomonas maltophilia infection were analyzed and described. Most of the infections occurred 2 weeks after admission, and the symptoms of respiratory infection were predominant. Patients with basic structural lung disease and malignant tumor were susceptible to infection of Stenotrophomonas maltophilia. Before infection, patients used carbapenem and cephalosporin broad-spectrum antibiotics, suffered from serious basic diseases, accepted various invasive operations, the elderly, low immunity. The patients were mainly distributed in intensive care unit, respiratory department and thoracic surgery. The drug sensitivity rate from high to low was minocycline 94.7). Trimethoprim sulfamethazolone 90.1%, levofloxacin 86.8%, cefoperazone-sulbactam 57.8%, ticacillin clavulanate 54.6). Ceftazidime 51.3%. There was no significant difference in drug sensitivity and drug resistance between geriatric and adult strains (P 0.05). Conclusion carbapenems and cephalosporins are widely used. Invasive operation, patients with decreased immunity are more likely to be infected with Stenotrophomonas maltophilia. Strengthen the detection of patients with Stenotrophomonas maltophilia, according to the drug sensitivity test rational use of antibiotics. It is an effective measure to treat the infection of Stenotrophomonas maltophilia.
【作者单位】：泰安市第一人民医院临床检验科;首都医科大学研究生院;
【分类号】：R446.5
【正文快照】： 近年来,随着广谱抗菌药物的广泛使用以及侵袭性诊治技术的普遍开展,广泛存在于环境中且天然耐碳青霉烯类药物的嗜麦芽窄食单胞菌(Stenotrophomonas maltophilia)形成优势生长,引起医院感染越来越多,其分离率在不发酵糖革兰阴性杆菌中仅次于铜绿假单胞菌和鲍曼不动杆菌,位居

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