CAJ | 학술논문

目的：分析本院重症监护病房（ICU）患者医院获得性感染洋葱伯克霍尔德菌的临床特点及对常用抗菌药物的耐药性，为临床合理治疗提供依据。方法回顾性分析2012年1月至2013年12月，从本院 ICU 患者送检的细菌培养标本中分离出32株洋葱伯克霍尔德菌的耐药情况。结果从检测部位分析，主要分布在下呼吸道（62．5％），其次为深静脉导管（12．5％）。药敏试验表明，32株洋葱伯克霍尔德菌对多种抗菌药物存在天然耐药，但对米诺环素、氯霉素、美罗培南、头孢他啶和头孢哌酮/舒巴坦仍较敏感，可作为临床治疗洋葱伯克霍尔德菌感染的首选药物。结论洋葱伯克霍尔德菌在 ICU 患者中的耐药现象非常严重，对洋葱伯克霍尔德菌多重耐药引起的感染，临床应引起高度关注，及早进行微生物学检测，并根据药敏试验结果合理选用抗菌药物。
목적：분석본원중증감호병방（ICU）환자의원획득성감염양총백극곽이덕균적림상특점급대상용항균약물적내약성，위림상합리치료제공의거。방법회고성분석2012년1월지2013년12월，종본원 ICU 환자송검적세균배양표본중분리출32주양총백극곽이덕균적내약정황。결과종검측부위분석，주요분포재하호흡도（62．5％），기차위심정맥도관（12．5％）。약민시험표명，32주양총백극곽이덕균대다충항균약물존재천연내약，단대미낙배소、록매소、미라배남、두포타정화두포고동/서파탄잉교민감，가작위림상치료양총백극곽이덕균감염적수선약물。결론양총백극곽이덕균재 ICU 환자중적내약현상비상엄중，대양총백극곽이덕균다중내약인기적감염，림상응인기고도관주，급조진행미생물학검측，병근거약민시험결과합리선용항균약물。
Objective To analyze the clinical characteristics and resistance to commonly used antibacterial drugs in the intensive care unit(ICU)patients with hospital-acquired Burkholderia cepacia infection in order to provide the basis for clinical rational treatment.Methods The drug resistance situation in 32 strains of Burkholderia cepacia isolated from the bacterial culture speci-mens submitted by ICU of our hospital from January 2011 to December 2012 was performed the retrospective analysis.Results In the detection sites,the infection was mainly distributed in the lower respiratory tract (62.5%),followed by deep venous catheter (12.5%);the drug susceptibility test revealed that 32 strains of Burkholderia cepacia showed the natural resistance to multiple antibacterial drugs,but which were still sensitive to minocycline,chloromycetin,meropenem,ceftazidime,cefoperazone/sulbactam, these drugs could be used as the first choice of drugs for treating Burkholderia cepacia infection.Conclusion The drug resistance phenomenon of Burkholderia cepacia is very serious in the ICU patients.Clinic should pay great concern to the infections caused by multi-drug resistant Burkholderia cepacia ,the microbiological testing should be conducted as early as possible,and the antibacterial drugs should be rationally selected according to the drug susceptibility testing results.