目的：探讨山西医科大学第二医院住院患者临床分离的150株洋葱伯克霍尔德菌的耐药性及其病例的临床特点。方法：采用药物敏感性试验纸片扩散法，测定洋葱伯克霍尔德菌对5种抗菌药物的耐药性，并对分离出该致病菌的病例资料进行回顾性分析。结果：150株洋葱伯克霍尔德菌中，126株来自痰标本，6例来自血液标本，2例来自中心静脉置管，10例来自引流液及分泌物，来自尿液、粪便和咽拭子各2例；洋葱伯克霍尔德菌对美罗培南、亚胺培南、复方磺胺甲唑、米诺环素、头孢他啶的敏感率分别为63.22％、14.3％、75.82％、65.47％、76.00％。150株洋葱伯克霍尔德菌来自112例患者，均合并2种以上基础疾病，其中，合并其他细菌感染89例，留置导管92例；在培养出该致病菌前均使用过抗菌药物，其中，61例使用了碳青霉烯类抗菌药物。培养出该致病菌患者的平均住院时间为（31.38±24.56） d；112例患者中，治愈17例（占15.18％），好转65例（占58.04％），死亡22例（占19.64％），放弃治疗8例（占7.14％）。结论：合并基础疾病、住院时间长、留置导管、抗菌药物选用品种过高及疗程过长等为洋葱伯克霍尔德菌感染的主要危险因素，临床可首选复方磺胺甲唑、头孢他啶进行治疗。%OBJECTIVE:To investigate the drug resistance and clinical characteristics of the 150 strain of Burkholderia cepacia isolated from the patients in The Second Hospital of Shanxi Medical University .METHODS:The susceptibility of Burkholderia cepacia strains to five kinds of antimicrobial agents was detected by disk diffusion method, and the data of the patients with positive Burkholderia cepacia strains were analyzed retrospectively . RESULTS:Of the total 150 strains of Burkholderia cepacia ,126 strains were isolated from sputum specimens , 6 blood specimens , 2 central venous catheter specimens , 10 drainage fluid and secretion , 2 urine specimen , 2 feces and 2 throat swab specimen.The sensitive rates of Burkholderia cepacia to meropenem , imipenem, selectrintrimesulf, minocycline and ceftazidime were 63.22%, 14.3%, 75.82%, 65.47%and 76.00%, respectively .The 150 strains of Burkholderia cepacia were isolated from a total of 112 patients , and these patients had at least two underlying diseases, with 89 patients(87.8%) complicated with other bacterial infection , 92(86.6%) indwelling catheter, and all these patients used antimicrobial drugs before culture of Burkholderia cepacia , among them , 61 patients used Carbapenems .The average length of hospital stay for these patients in whom Burkholderia cepacia were isolated was (31.38 ±24.56) days.Among the 112 cases, 17 cases were cured (15.18%), 65 took a turn for the better (58.04%), 22 cases died(19.64%) and 8 cases had gave up treatment(7.14%).CONCLUSIONS:The major risk factors for Burkholderia cepacia infection includes underlying diseases , long hospital stay , indwelling catheters , selecting high level of antimicrobial drugs and prolonged duration of medication .Cotrimoxazole and ceftazidime should be used as first choice in clinical treatment of Burkholderia cepacia infection .
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