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嗜麦芽窄食单胞菌:土耳其一家大学医院中一种新兴病原体的抗菌药物耐药性及分子分型

Stenotrophomonas maltophilia: antimicrobial resistance and molecular typing of an emerging pathogen in a Turkish university hospital.

作者信息

Gülmez D, Hasçelik G

机构信息

Department of Microbiology and Clinical Microbiology, Faculty of Medicine, Hacettepe University, Ankara, Turkey.

出版信息

Clin Microbiol Infect. 2005 Nov;11(11):880-6. doi: 10.1111/j.1469-0691.2005.01257.x.

Abstract

Despite its limited pathogenicity, Stenotrophomonas maltophilia is an emerging nosocomial pathogen. This study investigated the isolation frequency, antimicrobial resistance and genotypic relationships of 205 S. maltophilia isolates from 188 patients in a university hospital between 1998 and 2003. Susceptibility profiles for 11 antimicrobial agents were determined by the NCCLS agar dilution method for non-fermentative bacteria, while enterobacterial repetitive intergenic consensus sequence (ERIC)-PCR and pulsed-field gel electrophoresis (PFGE) were used for genotyping of the isolates. Of the 205 isolates, 56.1% were isolated in the last 2 years of the study. The risk of S. maltophilia isolation was higher in intensive care units, S. maltophilia was isolated mostly (86.8%) after hospitalisation for >or= 48 h, and 90.4% of the patients had underlying diseases. Resistance levels were>60% for all antimicrobial agents tested except co-trimoxazole. High genetic diversity was found among the S. maltophilia isolates, and cross-infection with S. maltophilia was not common. Although ERIC-PCR revealed fewer genotypes than PFGE, it proved to be a rapid and easy method for S. maltophilia genotyping, and was more economical than PFGE.

摘要

尽管嗜麦芽窄食单胞菌致病性有限,但它仍是一种新出现的医院感染病原菌。本研究调查了1998年至2003年间从一所大学医院188例患者中分离出的205株嗜麦芽窄食单胞菌的分离频率、耐药性及基因分型关系。采用美国国家临床实验室标准化委员会(NCCLS)针对非发酵菌的琼脂稀释法测定了11种抗菌药物的敏感性,同时采用肠杆菌基因间重复一致序列(ERIC)-PCR和脉冲场凝胶电泳(PFGE)对分离株进行基因分型。在这205株分离株中,56.1%是在研究的最后2年分离得到的。嗜麦芽窄食单胞菌在重症监护病房的分离风险更高,该菌大多(86.8%)在住院≥48小时后分离得到,且90.4%的患者有基础疾病。除复方新诺明外,所有受试抗菌药物的耐药率均>60%。嗜麦芽窄食单胞菌分离株间存在高度的基因多样性,嗜麦芽窄食单胞菌的交叉感染并不常见。虽然ERIC-PCR显示的基因型比PFGE少,但它被证明是一种快速简便的嗜麦芽窄食单胞菌基因分型方法,且比PFGE更经济。

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