重症监护病房洋葱伯克霍尔德菌医院感染的特征及耐药性分析

目的了解重症监护病房（ICU）洋葱伯克霍尔德菌引起医院感染的特征及耐药情况，为临床治疗及控制该菌的暴发流行提供实验依据。方法常规方法对我院2003年1月至2007年10月ICU的病人的各种临床标本进行分离培养，细菌鉴定及药敏试验采用全自动微生物鉴定仪VITEK-2进行。结果引起ICU医院感染的洋葱伯克霍尔德菌共有99例，感染以肺部感染为主，对临床常用的多种抗菌药物表现交叉耐药，对头孢匹肟、亚胺培南、哌拉西林、阿米卡星、庆大霉素的敏感率较差在50．0％以下；对环丙沙星、左氧氟沙星、头孢他啶、氨曲南、哌拉西林／他唑巴坦、美诺培南和复方新诺明的敏感率较高，分别为82．8％、87．9％、91．9％、72．7％、55．6％、62．6％和100．0％。结论引起ICU医院感染的洋葱伯克霍尔德菌具有多重耐药性，临床治疗时应根据药敏结果选用抗菌药物。

Analysis of the distribution and drug-resistance of Burkholderia cepacia in hospital infection

Objective To investigate the distribution and drug-resistance of Burkholderia cepacia from intensive care units(ICU),and provide the experimental evidence for clinical therapy especially in controlling the outbreak of Burkholderia cepacia infection. Methods 99 clinical specimens of Burkholderia cepacia infection in our hospital's ICU were collected from Jan 2003 to Oct 2007.Identification of the bacteria and antibiotics susceptibility were performed on VITEK2 all-automatic microbiology analysis system. Results Lungs were the main organ associated with Burkholderia cepacia infection in ICU.Burkholderia ceparia showed cross-resistence to multiple antibiotics.Antimicrobial susceptibility test showed that the susceptibility rate of Burkholderia cepacia to imipenem,piperacillin,amikacin and gentamycin is lower than 50%;and the susceptibility rate to ciprofloxacin,levofloxacin,ceftazidime,aztreonam,piperacillin/Tazobactam,Meropeneman,Trimethoprim/Sulfamethoxo were 82.8%,87.9%,91.9%,72.7%,55.6%,62.6% and 100.0%,respectively. Conclusion Burkholderia cepacia is multi-resistant to most antimicrobial agents.In the treatment of clinical Burkholderia cepacia infection,antimicrobial drugs should be selected according to the results of antimicrobial susceptibility test.