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金黄杆菌下呼吸道感染的临床特征及其药物敏感性

Lower respiratory tract infection caused by Chryseobacterium and its susceptibility to drugs
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摘要 目的 :探讨金黄杆菌致下呼吸道感染的临床特征及其对抗生素的敏感性 ,以指导临床诊断及治疗。 方法 :研究 5 2例金黄杆菌致下呼吸道感染的临床资料 ,采用平板稀释法测定常用抗生素对该菌株的最低抑菌浓度 ,测定金黄杆菌对小鼠的半数致死量 (LD50 )。 结果 :5 2例中 >6 0岁者 36例 ,全部病例均有基础疾病 ,主要为慢性阻塞性肺疾病、恶性肿瘤。气管插管或气管切开 1 7例 ,35例有长期应用广谱抗生素史 ,感染前患者的住院时间平均为 35 .6d。 2 0例 (38.5 % )为混合感染。临床症状及X线表现缺乏特异性。药敏试验提示该菌耐药性广 ,舒哌酮、氧氟沙星、环丙沙星、复方磺胺甲唑及哌拉西林为相对敏感抗生素。 2 0株菌株的LD50 范围为 4 .1 1× 1 0 6~ 5 .6 8× 1 0 8/mouse ,提示该菌属的毒力相对较弱。 结论 :金黄杆菌毒力较弱 ,其所致下呼吸道感染多发生于有基础疾病、免疫力低下、长期使用抗生素的老龄患者 ,细菌耐药率高 ,临床表现缺乏特异性 。 Objective: To investigate the characteristics of lower respiratory tract infection caused by Chryseobacterium and its antimicrobial susceptibility in vitro . Methods: The clinical data of 52 cases of lower respiratory tract infection caused by Chryseobacterium were analyzed, and the antimicrobial susceptibility of commonly used agents was determined with the method of agar dilution. Also the 50% lethal dosage (LD 50 ) (as the marker of virulence) of 20 randomly selected Chryseobacterium strains for mice were determined. Results: (1) Thirty six was over 60 years old;all of 52 cases had underlying diseases, mainly were chronic obstruction pulmonary disease and malignant tumors. Seventeen cases had the history of incubation or tracheotomy for mechanical ventilation, and 35 had history of broad antibiotics treatment. The mean hospitalization time before infection were 35.6 d, and 38.5% of the cases had mixed infection with other bacteria. No specific clinical manifestations and chest X ray appearance revealed. (2) The in vitro activity of 25 agents showed that these strains were highly resistant. (3) The range of the LD 50 of tested strains was 4.11×10 6 5.68×10 8/mouse, suggesting low virulence of this kind of bacteria. Conclusion: The lower respiratory tract infection caused by Chryseobacterium has no unique features; the incidence of the infection increases in immunosuppressed old patients with various underlying diseases, although the virulence is relatively low. Because the clinical isolates are highly resistant, the antibiotics should be selected according to the results of bacterial sensitivity test.
出处 《第二军医大学学报》 CAS CSCD 北大核心 2003年第9期1016-1018,共3页 Academic Journal of Second Military Medical University
基金 国家自然科学基金 ( 3 0 2 0 0 116)
关键词 金黄杆菌 下呼吸道感染 临床特征 抗生素 药物敏感性 诊断 治疗 Chryseobacterium lower respiratory tract infection clinical characteristics microbial sensitivity tests
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