2012年中国CHINET嗜麦芽窄食单胞菌耐药性监测
2012년중국CHINET기맥아착식단포균내약성감측
CHINET 2012 antimicrobial rsistance surveillance in Stenotrophomonas maltophilia across China
  • 万方数据
    中国感染与化疗杂志 중국감염여화료잡지
    CHINESE JOURNAL OF INFECTION AND CHEMOTHERAPY
    2014年 6期 488-492 ,共5页

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

    애효만%호운건%호지동%리전%손자용%진중거%서영춘%장소강%왕복%주덕매%호부품%예어성%손경용%탁초%소단홍%서원굉%침계록%유운송%림길%단빈%두염%장조하%계평%저운탁%위연화%오령%왕전청%왕애민%장홍%공정

    嗜麦芽窄食单胞菌%不发酵糖革兰阴性杆菌%抗菌药物%药敏试验 嗜麥芽窄食單胞菌%不髮酵糖革蘭陰性桿菌%抗菌藥物%藥敏試驗
    기맥아착식단포균%불발효당혁란음성간균%항균약물%약민시험
    Stenotrophomonas maltophilia%glucose nonfermenter%antimicrobial agent%antimicrobial susceptibility testing
    目的：了解国内不同地区15所医院2012年临床分离嗜麦芽窄食单胞菌对抗菌药物的耐药性。方法对国内主要地区15所医院2012年收集的临床非重复嗜麦芽窄食单胞菌菌株，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 2012年标准判读结果。结果全年共收集2156株嗜麦芽窄食单胞菌。其中住院患者分离2103株，占97．5％；门诊患者分离53株，占2．5％。60岁及以上的老年患者分离1410株，占65．4％，小于18岁的患者分离115株，占5．3％。分离自痰液等呼吸道分泌物标本1770株，占82．1％；分离自血液、胸腹水、关节腔液、脑脊液等无菌体液标本81株，占3．8％。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10．0％、10．5％和3．8％，对头孢哌酮‐舒巴坦的耐药率为24．4％。结论嗜麦芽窄食单胞菌主要分离于住院患者及其痰液等呼吸道标本，且多见于60岁及以上的老年患者。该菌对大多数常用抗菌药物固有耐药，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‐舒巴坦对该菌亦有较好抗菌活性。临床应以药敏试验结果合理选用治疗嗜麦芽窄食单胞菌的抗菌药物。
    목적：료해국내불동지구15소의원2012년림상분리기맥아착식단포균대항균약물적내약성。방법대국내주요지구15소의원2012년수집적림상비중복기맥아착식단포균균주，안통일방안급재료、채용지편확산법혹자동화의기법진행세균약민시험，안조CLSI 2012년표준판독결과。결과전년공수집2156주기맥아착식단포균。기중주원환자분리2103주，점97．5％；문진환자분리53주，점2．5％。60세급이상적노년환자분리1410주，점65．4％，소우18세적환자분리115주，점5．3％。분리자담액등호흡도분비물표본1770주，점82．1％；분리자혈액、흉복수、관절강액、뇌척액등무균체액표본81주，점3．8％。해균대갑양변정‐광알갑구악서、좌양불사성화미낙배소적내약솔분별위10．0％、10．5％화3．8％，대두포고동‐서파탄적내약솔위24．4％。결론기맥아착식단포균주요분리우주원환자급기담액등호흡도표본，차다견우60세급이상적노년환자。해균대대다수상용항균약물고유내약，단대CLSI추천적갑양변정‐광알갑구악서、좌양불사성화미낙배소적내약솔저。두포고동‐서파탄대해균역유교호항균활성。림상응이약민시험결과합리선용치료기맥아착식단포균적항균약물。
    Objective To investigate the antimicrobial resistance of clinical Stenotrophomonas maltophilia isolates from 15 hospitals in several regions of China during 2012 . Methods Fifteen representative general hospitals were involved in this program .Bacterial susceptibility testing was carried out by means of a unified protocol using Kirby‐Bauer method and minimum inhibitory concentration ( M IC ) determination .The results were analyzed according to the 2012 CLSI breakpoints .Results Most (97 .5% ) of the 2 156 clinical strains of S . maltophilia were isolated from inpatients .Only 2 .5% of the isolates were from outpatients . About 65 .4% (1 410/2 156) of the strains were isolated from old patients at least 60 years of age ,and only 5 .3% (115/2 156) were from patients of 18 years old or younger .Sputum and respiratory tract secretion were the most common specimen source , accounting for 82 .1% .And 3 .8% of the isolates were from blood ,abdominal fluid and other sterile body fluids .About 10 .0% ,10 .5 % ,3 .8 % and 24 .4% of the S . maltophilia strains were resistant to trimethoprim‐sulfamethoxazole , levofloxacin , minocycline , and cefoperazone‐sulbactam , respectively . Conclusions Majority of S . maltophilia strains are isolated from respiratory tract specimens of inpatients .Such strains are usually isolated from old patients at lease 60 years of age .The S . maltophilia strains are intrinsically resistant to most antibacterial agents , but still show low resistance to trimethoprim‐sulfamethoxazole ,levofloxacin and minocycline .Antimicrobial therapy for S .maltophiliastrains should be based on the results of antimicrobial susceptibility testing .
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