医院内洋葱伯克霍尔德菌感染的流行病学调查及耐药性分析

目的：分析医院内洋葱伯克霍尔德菌感染的流行病学和耐药性,为临床预防和抗感染治疗提供科学的依据。方法：采用法国梅里埃公司生产的VITEK 32全自动微生物鉴定系统对金华市某医院细菌室2005￣2007年度分离的57株洋葱伯克霍尔德菌进行分析,K-B纸片法做药敏试验并用NCCLS标准判定结果。结果：洋葱伯克霍尔德菌各科室分布为：ICU 37株,占64.8%;神经内科8株,占14.0%;呼吸内科3株,占5.3%等。在标本中的分布为：痰液55株,占96.4%;尿液1株,占1.8%;穿刺液1株,占1.8%。该菌对常用抗菌药物的耐药率以妥布霉素的耐药率最高,为91.1%,头孢哌酮/舒巴坦的耐药率最低,为5.4%。结论：洋葱伯克霍尔德菌在临床上的分离率有上升趋势,尤其在ICU室,已经成为医院感染的重要病原菌之一;该菌可通过污染的自来水、体温表、导管、喷雾气、介入性治疗、呼吸道等途径感染,且对多数抗菌药物具有较高的耐药性,有不断增加的趋势,监测其耐药性和耐药趋势具有重要的临床指导意义。

Epidemiological Survey and Drug-resistant Analysis on Burkholderia Cepacia in Nosocomial Infections

Objective：To analyze epidemiological situation and drug resistance feature in Burkholderia cepacia to provide reference for controlling and treating infection led by it.Methods：57 strains of Burkholderia cepacia isolated from patients with infection were identified by Vitek-AMS（Automated Microbic System）and their antibiotics susceptivity were analyzed by Kirby-Bauer（K-B） test according to National Committee for Clinical Laboratory Standards（NCCLS） guideline.Results：Among a total of 57 strains of Burkholderia cepacia,the main distributed departments were intensive care unit（ICU）（64.8%）,department of neurology（14.0%） and department of respiratory diseases and the main isolated specimen were sputum（96.4%）,urine（1.8%） and pucture fluid（1.8%）.In the resistant rate of Burkholderia cepacia to commonly used antibiotics,tobramycin showed the highest rate（91.1%）.In contrast,cefoperazone/sulbactam showed the lowest resistant rate（5.4%）.Conclusion：The isolating rate of Burkholderia cepacia is increasingly rising in clinical department in the past years.Especially,it has become the major pathogen in ICU.In addition,it can be disseminated through many ways such as contaminated equipment,interventional therapy,respiratory tract,etc.As a result,monitoring of drug resistance for Burkholderia cepacia is very significant to instruct reasonable application of antibiotics in order to infection diseases control and hospital infection management.