2011年中国 CHINET 嗜麦芽窄食单胞菌耐药性监测
2011년중국 CHINET 기맥아착식단포균내약성감측
CHINET 2011 surveillance of antibiotic resistance in Stenotrophomonas malto-philia in China
  • 万方数据
    中国感染与化疗杂志 중국감염여화료잡지
    CHINESE JOURNAL OF INFECTION AND CHEMOTHERAPY
    2014年 2期 94-99 ,共6页

    艾效曼%胡云建%俞云松%杨青%倪语星%孙景勇%徐英春%张小江%孙自镛%陈中举%汪复%朱德妹%胡付品%卓超%苏丹虹%徐元宏%沈继录%单斌%杜艳%魏莲花%吴玲%张朝霞%季萍%王传清%王爱敏%贾蓓%黄文祥%张泓%孔菁

    애효만%호운건%유운송%양청%예어성%손경용%서영춘%장소강%손자용%진중거%왕복%주덕매%호부품%탁초%소단홍%서원굉%침계록%단빈%두염%위연화%오령%장조하%계평%왕전청%왕애민%가배%황문상%장홍%공정

    嗜麦芽窄食单胞菌%不发酵糖革兰阴性杆菌%抗菌药物 嗜麥芽窄食單胞菌%不髮酵糖革蘭陰性桿菌%抗菌藥物
    기맥아착식단포균%불발효당혁란음성간균%항균약물
    Stenotrophomonas maltophilia%glucose nonfermenter%antimicrobial agent
    目的：了解国内不同地区15所医院2011年临床分离嗜麦芽窄食单胞菌对抗菌药物的敏感性。方法收集15所医院2011年临床分离嗜麦芽窄食单胞菌1889株，按统一方案及材料、采用纸片扩散法或自动化仪器法进行细菌药敏试验，按照 CLSI 2011年标准判读结果。结果监测的1889株嗜麦芽窄食单胞菌主要分离自住院患者，占93．3％；门诊患者分离株占6．7％。60岁及以上的老年患者分离株占62．9％，小于18周岁患者的分离株占8．2％。痰液等呼吸道分泌物是该菌的主要分离源，占82．6％；分离自血液、胸腹水、关节腔液、脑脊液等无菌体液菌株占4．2％。该菌对甲氧苄啶-磺胺甲口恶唑、左氧氟沙星和米诺环素的耐药率分别为16．6％、10．0％和1．8％，对头孢哌酮-舒巴坦的耐药率为19．0％。血液及无菌体液分离株对甲氧苄啶-磺胺甲口恶唑的耐药率为37．1％，高于其他标本分离株，与伤口及尿液标本比较，P 值＜0．01。结论嗜麦芽窄食单胞菌主要分离自住院患者及其痰液等呼吸道标本中，且60岁以上的老年患者多见。该菌对多种抗菌药物固有耐药，但对 CLSI推荐的甲氧苄啶-磺胺甲口恶唑、左氧氟沙星和米诺环素的耐药率低。头孢哌酮-舒巴坦对该菌亦有抗菌活性。应以药敏试验结果合理选用治疗嗜麦芽窄食单胞菌感染的抗菌药物。
    목적：료해국내불동지구15소의원2011년림상분리기맥아착식단포균대항균약물적민감성。방법수집15소의원2011년림상분리기맥아착식단포균1889주，안통일방안급재료、채용지편확산법혹자동화의기법진행세균약민시험，안조 CLSI 2011년표준판독결과。결과감측적1889주기맥아착식단포균주요분리자주원환자，점93．3％；문진환자분리주점6．7％。60세급이상적노년환자분리주점62．9％，소우18주세환자적분리주점8．2％。담액등호흡도분비물시해균적주요분리원，점82．6％；분리자혈액、흉복수、관절강액、뇌척액등무균체액균주점4．2％。해균대갑양변정-광알갑구악서、좌양불사성화미낙배소적내약솔분별위16．6％、10．0％화1．8％，대두포고동-서파탄적내약솔위19．0％。혈액급무균체액분리주대갑양변정-광알갑구악서적내약솔위37．1％，고우기타표본분리주，여상구급뇨액표본비교，P 치＜0．01。결론기맥아착식단포균주요분리자주원환자급기담액등호흡도표본중，차60세이상적노년환자다견。해균대다충항균약물고유내약，단대 CLSI추천적갑양변정-광알갑구악서、좌양불사성화미낙배소적내약솔저。두포고동-서파탄대해균역유항균활성。응이약민시험결과합리선용치료기맥아착식단포균감염적항균약물。
    Objective To investigate the resistance of clinical Stenotrophomonas maltophilia isolates from 15 hospitals in several regions of China during 2011.Methods Fifteen repre-sentative general hospitals were involved in this program. Bacterial susceptibility testing was carried out by means of a unified protocol using Kirby-Bauer method and MIC determi-nation.Results were analyzed according to CLSI 2011 break-points.Results Majority (93.3%) of the 1 889 clinical strains of S.maltophilia were isolated from inpatients.On-ly 6.7% of the isolates were from outpatients.About 62.9% of these S .maltophilia strains were isolated from old patients whose age was 60 years or older.Only 8.2% of the strains were from the patients younger than 18 years old.Sputum and re-spiratory tract secretion were the most common specimen source,accounting for 82.6%.Another 4.2% isolates were from blood,abdominal fluid and other sterile body fluids.The percentage of the S .maltophilia strain resistant to trimethoprim-sul-famethoxazole,levofloxacin and minocycline was 16.6%,10.0% and 1.8%,respectively.The strains resistant to cefopera-zone-sulbactam accounted for 19.0%.About 37.1% of the strains isolated from blood or sterile body fluids were resistant to trimethoprim-sulfamethoxazole,significantly higher than the strains from urine or wound specimens (P < 0.01).Conclusions S.maltophilia strains are mainly isolated from inpatients.The most common source is sputum and other respiratory speci-mens.Most of the patients with S.maltophilia isolate are 60 years of age or older.The S.maltophilia strains are constitu-tively resistant to several antibacterial agents,but showed relatively lower resistance to trimethoprim-sulfamethoxazole,levo-floxacin and minocycline.Cefoperazone-sulbactam is still active against these strains.The antimicrobial therapy targeting S. maltophilia infections should be selected cautiously according to the results of antimicrobial resistance surveillance.
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