摘要
目的分析唐菖蒲伯克霍尔德菌的临床分布和耐药性,为相关疾病的防治提供流行病学诊断依据。方法选取新乡医学院第一附属医院2013年1月至2016年11月86 412例住院患者为研究对象,其中符合菌血症诊断标准者81 807例,符合脑膜炎诊断标准者4 605例,对其血液、骨髓、脑脊液标本进行细菌培养、菌种鉴定及药物敏感性试验,并用WHONET 5.5软件进行数据统计分析。利用瑞美软件分析总结白细胞计数(WBC)、C反应蛋白(CRP)、红细胞沉降率(ESR)、纤维蛋白原(FIB)等相关炎症指标以及携带病毒感染情况。结果 86 412例住院患者共分离出唐菖蒲伯克霍尔德菌145株,总检出率为0.17%;122例(84.14%)伴有基础性疾病;血液标本中检出率最高,占0.17%,男性(0.22%)高于女性(0.10%),≥18岁组(0.23%)高于<18岁组(0.05%),感染科占比例最高(28.97%)。体外抗菌药物敏感性试验结果显示,唐菖蒲伯克霍尔德菌对庆大霉素、头孢唑林、氨苄西林、哌拉西林、复方新诺明、氨曲南、阿莫西林/克拉维酸7种药物的耐药率在50.00%以上,其中对氨曲南、阿莫西林/克拉维酸高度耐药,耐药率分别是87.58%和80.00%,多耐株比例为48.97%。该菌与炎症指标阳性符合率高(91.03%),携带病毒感染率为7.59%。结论应重视唐菖蒲伯克霍尔德菌引起的血流感染,加强防护伴有基础性疾病患者。因耐药形势严峻,临床应辅助炎症指标协助诊断,重视携带病毒感染患者,依据药物敏感性报告合理用药、联合用药。
Objective To analyze the clinical distribution and drug resistance of Burkholderia gldioli,so as to provide epidemiological evidence for prevention and treatment of related diseases. Methods A total of 86 412 hospitalized patients in the First Affiliated Hospital of Xinxiang Medical University from January 2013 to November 2016 were selected as the subjects,including 81 807 patients who met the diagnostic criteria of bacteremia,and 4 605 patients who met the diagnostic criteria of meningitis. The blood,bone marrow and cerebrospinal fluid samples were collected for bacterial culture,strain identification and drug sensitivity test. The data were analyzed by WHONET 5. 5 software. The carrying viral infection and the related inflammation markers including white blood cell count（ WBC）,C-reactive protein（ CRP）,erythrocyte sedimentation rate（ ESR） and fibrinogen（ FIB） were analyzed and summarized by Reimei software. Results There were 145 strains of Burkholderia gldioli were isolated from 86 412 patients,the isolating rate was 0. 17%,and 122 cases were accompanied by basic diseases（ 84. 14%）. The isolating rate of blood specimens was the highest（ 0. 17%）. The isolating rate in mail was higher than that in female（ 0. 22% vs 0. 10%）,the isolating rate in the patients with more than 18 years old was higher than that in the patients with less than 18 years old（ 0. 23% vs 0. 05%）,the proportion was the highest in the department of infectious diseases（ 28. 97%）. In vitro drug sensitivity test showed that the resistance rate of Burkholderia gladioli to gentamicin,cefazolin,ampicillin,piperacillin,cotrimoxazole,aztreonam,amoxicillin clavulanic acid was more than 50%; the resistance rate of Burkholderia gladioli to aztreonam and amoxicillin clavulanic acid was 87. 58% and 80. 00% respectively; the proportion of multi drug resistant strains was 48. 97%. The coincidence rate of Burkholderia gldioli and inflammatory markers was high（ 91. 03%）,and the carrying viral infection rate was 7. 59%.
出处
《新乡医学院学报》
CAS
2017年第12期1107-1110,1113,共5页
Journal of Xinxiang Medical University
关键词
唐菖蒲伯克霍尔德菌
临床分布
耐药性
Burkholderia gldioli
clinical distribution
drug resistance
