摘要
目的探讨老年呼吸疾病患者嗜麦芽窄食单胞菌(SMA)感染及耐药情况。方法选择2013年至2017年期间住院的3 719例老年呼吸疾病患者,分离所有SMA感染患者痰标本中的SMA,并检测其耐药性、整合酶基因及耐药基因。结果 3 719例患者中,有402例感染SMA,感染率为10. 8%,感染率呈逐年上升的趋势(P <0. 05)。SMA对头孢他啶、替卡西林/克拉维酸、米诺环素、复方新诺明、替加环素和左氧氟沙星的耐药率均呈逐年增加的趋势(均P <0. 05)。SMA的消毒剂-磺胺类耐药基因1、Ⅰ类整合子1类整合酶(IntⅠ1)、甲氧苄啶耐药基因dfrA12阳性率呈逐年上升的趋势(P <0. 05)。耐药菌株的IntⅠ1检出率高于非耐药菌株(P <0. 05)。结论老年呼吸疾病住院患者SMA感染率较高,其SMA感染率及耐药率呈逐年增加的趋势可能与整合酶基因有关。
Objective To explore the infection and drug resistance of Stenotrophomonas maltophilia(SMA)in elderly hospitalized patients with respiratory diseases.Methods A total of 3 719 elderly hospitalized patients with respiratory diseases from 2013 to 2017 were selected,SMA was isolated from sputum specimens of all patients,and drug resistance,integrase gene and drug resistance gene of SMA were detected.Results Of all 3 719 patients,402 patients were infected with SMA with a rate of 10.8%,and the rate showed an increasing trend year by year(all P<0.05).The drug resistance rates of SMA to ceftazidime,ticarcillin/clavulanic acid,minocycline,compound sulfamethoxazole,tigecycline and levofloxacin increased year by year(all P<0.05).Positive rates of SMA disinfectant-sulfonamide resistance gene 1,classⅠintegron class 1 integrase(IntⅠ1)and trimethoprim resistance gene dfrA12 increased year by year(all P<0.05).Detection rate of IntⅠ1 was higher in drug-resistant strains than in non-drug-resistant strains(P<0.05).Conclusion Elderly hospitalized patients with respiratory diseases have higher SMA infection rate,and the increasing trend of SMA infection rate and drug resistance rate may be related to integrase gene.
作者
杨子林
陈键
YANG Zi-lin;CHEN Jian(University of South China,Hengyang 421000,China;Department of Clinical Laboratory,Hunan Province People′s Hospital & the First Affiliated Hospital of Hunan Normal University,Changsha 410016,China)
出处
《广西医学》
CAS
2019年第2期229-232,237,共5页
Guangxi Medical Journal
基金
湖南省卫生和计划生育委员会科研计划课题(B2016022)
关键词
呼吸疾病
老年住院患者
嗜麦芽窄食单胞菌
耐药
整合酶基因
Respiratory disease
Elderly hospitalized patients
Stenotrophomonas maltophilia
Drug-resistance
Integrase gene
