中国感染与化疗杂志
中國感染與化療雜誌
중국감염여화료잡지
CHINESE JOURNAL OF INFECTION AND CHEMOTHERAPY
2014年
2期
112-115
,共4页
胡田雨%曲俊彦%谢轶%吕晓菊
鬍田雨%麯俊彥%謝軼%呂曉菊
호전우%곡준언%사질%려효국
嗜麦芽窄食单胞菌%无菌体液%危险因素%抗菌药物
嗜麥芽窄食單胞菌%無菌體液%危險因素%抗菌藥物
기맥아착식단포균%무균체액%위험인소%항균약물
Stenotrophomonas maltophilia%sterile body fluid%risk factor%antibiotic
目的:分析无菌部位嗜麦芽窄食单胞菌的感染情况、感染危险因素及耐药情况,为临床防治嗜麦芽窄食单胞菌感染提供相关依据。方法回顾性分析2009年1月-2011年12月无菌部位嗜麦芽窄食单胞菌培养阳性患者的临床特点及药敏结果。结果共收集嗜麦芽窄食单胞菌感染非重复患者54例,细菌所致血流感染20例(37.0%)、胆道感染16例(29.6%)、腹膜炎6例(11.1%)、脑膜炎4例(7.4%)、胸膜炎4例(7.4%)、关节炎2例(3.7%)、心包炎1例(1.9%)、眼内炎1例(1.9%)。临床科室分布以 ICU 为主。54例患者均有基础疾病;使用抗菌药物>7 d 者38例(70.4%);发病前曾行外科手术31例(57.4%);曾行侵袭性治疗27例(50.0%)、化疗5例(9.3%);使用糖皮质激素者2例(3.7%),使用免疫抑制剂2例(3.7%),所有患者均有以上至少一项危险因素。嗜麦芽窄食单胞菌对甲氧苄啶-磺胺甲口恶唑、左氧氟沙星、环丙沙星和替卡西林-克拉维酸的耐药率分别为7.4%、9.3%、57.4%和81.5%。结论嗜麦芽窄食单胞菌可引起易感者多个无菌部位的感染,耐药性明显,治疗困难,积极预防感染尤为重要。
目的:分析無菌部位嗜麥芽窄食單胞菌的感染情況、感染危險因素及耐藥情況,為臨床防治嗜麥芽窄食單胞菌感染提供相關依據。方法迴顧性分析2009年1月-2011年12月無菌部位嗜麥芽窄食單胞菌培養暘性患者的臨床特點及藥敏結果。結果共收集嗜麥芽窄食單胞菌感染非重複患者54例,細菌所緻血流感染20例(37.0%)、膽道感染16例(29.6%)、腹膜炎6例(11.1%)、腦膜炎4例(7.4%)、胸膜炎4例(7.4%)、關節炎2例(3.7%)、心包炎1例(1.9%)、眼內炎1例(1.9%)。臨床科室分佈以 ICU 為主。54例患者均有基礎疾病;使用抗菌藥物>7 d 者38例(70.4%);髮病前曾行外科手術31例(57.4%);曾行侵襲性治療27例(50.0%)、化療5例(9.3%);使用糖皮質激素者2例(3.7%),使用免疫抑製劑2例(3.7%),所有患者均有以上至少一項危險因素。嗜麥芽窄食單胞菌對甲氧芐啶-磺胺甲口噁唑、左氧氟沙星、環丙沙星和替卡西林-剋拉維痠的耐藥率分彆為7.4%、9.3%、57.4%和81.5%。結論嗜麥芽窄食單胞菌可引起易感者多箇無菌部位的感染,耐藥性明顯,治療睏難,積極預防感染尤為重要。
목적:분석무균부위기맥아착식단포균적감염정황、감염위험인소급내약정황,위림상방치기맥아착식단포균감염제공상관의거。방법회고성분석2009년1월-2011년12월무균부위기맥아착식단포균배양양성환자적림상특점급약민결과。결과공수집기맥아착식단포균감염비중복환자54례,세균소치혈류감염20례(37.0%)、담도감염16례(29.6%)、복막염6례(11.1%)、뇌막염4례(7.4%)、흉막염4례(7.4%)、관절염2례(3.7%)、심포염1례(1.9%)、안내염1례(1.9%)。림상과실분포이 ICU 위주。54례환자균유기출질병;사용항균약물>7 d 자38례(70.4%);발병전증행외과수술31례(57.4%);증행침습성치료27례(50.0%)、화료5례(9.3%);사용당피질격소자2례(3.7%),사용면역억제제2례(3.7%),소유환자균유이상지소일항위험인소。기맥아착식단포균대갑양변정-광알갑구악서、좌양불사성、배병사성화체잡서림-극랍유산적내약솔분별위7.4%、9.3%、57.4%화81.5%。결론기맥아착식단포균가인기역감자다개무균부위적감염,내약성명현,치료곤난,적겁예방감염우위중요。
Objective To investigate the risk factors and antibiotic resistance of Stenotrophomonas maltophilia infections to pro-vide evidence for rational antimicrobial therapy and prevention of S.maltophilia infections.Methods A retrospective analysis was carried out on 54 inpatients with S.maltophilia infections from January 2009 to December 2011.Results Most (20, 37.0%)of the diseases caused by S.maltophilia were bloodstream infection,followed by biliary infections (16,29.6%),peri-tonitis (6,11.1%),pleurisy (4,7.4%),meningitis (4,7.4%),arthritis (2,3.7%),pericarditis (1,1.9%),and endoph-thalmitis (1,1.9%).All the 54 patients had underlying diseases.The potential risk factors of S.maltophilia infections includ-ed antibiotic therapy lasting more than 7 days (38,70.4%),prior surgical operation (31,57.4%),prior invasive procedures (27,50.0%),chemotherapy (5,9.3%),prior use of corticosteroids (2,3.7%),and prior use of immunosuppressants (2, 3.7%).All the patients had at least one of the above risk factors.About 7.4%,9.3%,57.4% and 81.5% of the S.malto-philia isolates were resistant to trimethoprim-sulfamethoxazole,levofloxacin,ciprofloxacin and ticarcillin-clavulanic acid,re-spectively.Conclusions S.maltophilia can cause infections in various sterile body sites and shows significant resistance,which complicates the antimicrobial therapy.It is important to implement preventive measures to reduce the relevant risk factors.