目的 分析15例嗜麦芽窄食单胞菌败血症患者的临床因素及菌株同源性.方法 收集2006年9至12月浙江大学医学院附属第一医院肝移植病房的15例嗜麦芽窄食单胞菌败血症患者的临床资料,采用浓度梯度法(etest)测定15株细菌对10种常用抗菌药物的最小抑菌浓度(mic),通过whonet5软件对菌株进行抗生素分型,脉冲场凝胶电泳(pfge)分析菌株同源性.结果 所有患者均有机械通气史和长期使用广谱β-内酰胺类和喹诺酮类药物史,15株嗜麦芽窄食单胞菌在体外对米诺环素、复方磺胺甲恶唑和环丙沙星敏感性最好.抗生素型和pfge分析提示嗜麦芽窄食单胞菌败血症为局部流行,在不同时间段有克隆a(9株)和克隆b(6株)两个克隆株流行.结论 机械通气可能与肝移植患者发生嗜麦芽窄食单胞菌败血症有关.
abstract：
objective to investigate the related clinical factors and homology of strains in stenotrophomonas maltophilia (s. maltophilia) infections in 15 patients with liver transplantation. methods fifteen patients with s. maltophilia infection from september to december 2006 were enrolled and their clinical data were collected. minimal inhibitory concentrations (mics) of 10 antimierobial agents against s. maltophilia were determined by etest strips. antibiogram was carried out by resistance analysis assembly with whonet 5 software. the genomic dna of all the isolates was digested with xbal and subjected to pulse-field gel electrophoresis (pfge). results all patients received mechanical ventilation during the treatment and had a history of long-term use of extended-spectrum β-lactamases and quinolones. mics of 10 antimicrobial agents indicated that s. maltophilia were susceptible to several antimicrobial agents including compound sulfamethoxazole and ciprofloxacin, but the best active agent against these resistant isolates was minocycline in vitro. the results of all 15 s. maltophilia antibiograms were accordance with pfge patterns. all 15 s. maltophilia isolates were classified as 2 pfge patterns: 9 for pattern a and 6 for pattern b. conclusion mechanical ventilation might be associated with the s. maltophilia septicemia in patients with liver transplantation.
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