嗜麦芽窄食单胞菌下呼吸道感染98例临床特点及耐药性

摘要

目的 了解嗜麦芽窄食单胞菌(SMA)下呼吸道感染的临床特点及耐药性.方法 回顾性分析98例下呼吸道感染SMA的耐药性以及临床特点,分析发病的危险因素.结果 高龄、侵人性诊疗操作和使用广谱抗菌药物为SMA下呼吸道感染的危险因素,分别占76.5％、100％和82.6％.98株对常用抗菌药物耐药.近5年敏感率超过50％的抗菌药依次为复方磺胺甲噁唑(88.9％-100％)、头孢哌酮/舒巴坦(59.3％-77.8％)、左氧氟沙星(52.4％-64％)；对其他抗菌药物的耐药率均较高；其中,对亚胺培南耐药率达92.5％-100％.结论 SMA下呼吸道感染多发生在有各种基础疾病、免疫力低的患者.该菌表现为高度和多重耐药性,治疗应根据药敏试验结果合理选用抗菌药物.%Objective To investigate the clinical features and drug resistance of Stenotrophomonas maltophilia(SMA) in 98 patients with lower respiratory tract infectioa Methods The clinical features,drug resistance and related factors for disease development were retrospectively analysed in 98 patients with SMA lower respiratory tract infection. Results The risk factors for SMA infection included old age(76. 5%), invasive procedures (82. 6%) and the use of broad spectrum antibiotics(100%). The drug sensitivity tests in vitro showed that the antibiotics with sensitivity rate over 50% in recent 5 years were in an order of SMZ-TMP(88. 9%-100%)>cefoperazone/sulbactam (59. 3%-77. 8%)>levofloxacin(52. 4%-64%). The drug resistance rates of SMA to other antibiotics were higher,of which the resistance rate to imipenem was 92. 5%-100%. Conclusion The SMA is more often seen in the patients with severe underlying diseases and low immunity. SMA has high and multiple drug resistance rates and the antibiotic treatment should be based on drug susceptibility tests.