我院脑膜败血伊丽莎白菌的临床分布、产酶情况及耐药性分析
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篇名: 我院脑膜败血伊丽莎白菌的临床分布、产酶情况及耐药性分析
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摘要: 目的:探讨我院脑膜败血伊丽莎白菌的临床分布、产酶情况及耐药特征,为临床治疗和预防感染提供参考。方法:回顾性分析我院2011-2015年脑膜败血伊丽莎白菌致医院感染患者的临床资料,采用全自动细菌鉴定仪进行细菌鉴定,采用纸片扩散(K-B)法进行药敏试验,采用K-B法、双纸片增效法、改良三维试验法进行超广谱β-内酰胺酶(ESBLs)、头孢菌素酶(AmpC)、金属β-内酰胺酶(MBL)的表型确证。结果:共检出脑膜败血伊丽莎白菌76株,主要来源于痰液标本(75.0%),其患者主要来自于重症医学科(57.9%);76株脑膜败血伊丽莎白菌对亚胺培南、美罗培南、多黏菌素B、妥布霉素、庆大霉素、阿米卡星、头孢吡肟等7种抗菌药物的耐药率为100%,对利福平、复方磺胺甲噁唑等及3种含酶抑制剂的耐药率均<30%,对万古霉素、米诺环素的耐药率为0;58株细菌产ESBLs(76.3%),47株细菌产MBL(61.8%),未检出细菌产AmpC。结论:脑膜败血伊丽莎白菌可导致免疫力低下患者发生医院感染;该菌具有较高的耐药水平,可能与ESBLs、MBL高检出率有关;万古霉素与米诺环素是治疗该菌感染的首选药物。
ABSTRACT: OBJECTIVE: To discuss the clinical distribution, enzyme production and drug resistance of Elizabethkingia meningospetica in our hospital, and to provide evidence for clinical treatment and infection prevention. METHODS: Clinical information of the patients with hospital infection caused by E. meningospetica were analyzed retrospectively during 2011-2015. Automatic bacterial identification apparatus and K-B assay were used for bacterial identification and drug sensitivity test. Phenotype of ESBLs, AmpC and MBL were determined by K-B assay, double-disc synergy method and modified three-dimensional test. RESULTS: 76 strains of E. meningospetica were isolated, mainly from sputum sample (75.0%); the patients mainly came from the intensive care unit (57.9%). 76 strains of E. meningospetica were completely resistant to 7 antibiotics as imipenem, meropenem PMB to bramycin, gentamicin, amikacin and cefepime; resistant rate to rifampin, SMZ and 3 kinds of enzyme inhibitors were all lower than 30%; resistant rate to vancomycin and minocycline were equal to 0.58 strain of ESBLs-producing bacterial (76.3%) and 47 strains of MBL-producing bacterial (61.8%) were detected, and no AmpC-producing bacterial was found. CONCLUSIONS: E. meningospetica will cause hospital infection in low immunity patients; the bacterial is highly resistant to antibiotics, which is correlated to high detection rate of ESBLs and MBL. Vancomycin and minocycline are first choice for E. meningospetica therapy.
期刊: 2016年第27卷第14期
作者: 林美丽,吴俊琪,黄俊伟,应华永
AUTHORS: LIN Meili,WU Junqi,HUANG Junwei,YING Huayong
关键字: 脑膜败血伊丽莎白菌;医院感染;临床分布;产超广谱β-内酰胺酶;头孢菌素酶;金属β-内酰胺酶;耐药性
KEYWORDS: Elizabethkingia meningospetica; Hospital infection; Clinical distribution; ESBLs; AmpC; MBL; Drug resistance
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