危重患者尿液分离类香味菌属的临床实验室特点及耐药性分析
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摘要
目的对基层医院尿液分离类香味菌属患者的临床实验室特点及菌株的耐药性进行回顾性分析,为临床精准治疗提供依据,减少抗生素滥用。方法采用法国梅里埃全自动VITEK2 compact及配套试剂对2018年1～12月期间住院患者送检的尿液培养标本进行定量培养、鉴定及药敏分析。结果 2018年度住院患者送检尿液培养标本953份,占全部微生物送检标本(13 239份)的7.20%,检出病原菌300株,阳性率为31.5%,其中分离类香味菌属13株,占阳性标本的4.3%,标本来源:均为危重患者的留置导尿标本,药敏结果显示仅对四环素类药物敏感性较好,对其余多种抗生素高度耐药。结论该基层医院危重导尿患者尿液标本类香味菌属的分离率及耐药率均较高,应该引起临床高度重视,应合理分析其致病性及临床意义,精准诊断精准治疗,减少抗生素滥用。
Objective To retrospectively analyze the clinical laboratory characteristics and drug resistance of Aromatic bacteria isolated from urine in primary hospitals,so as to provide basis for precise clinical treatment and reduce the abuse of antibiotics.Methods Quantitative culture,identification and drug susceptibility analysis of urine culture specimens of inpatients from January to December 2018 were carried out by full automatic VITEK 2 compact and kit reagents from Meriere,France.Results 953 urine culture specimens were sent to inpatients in 2018,accounting for 7.20% of all microbial samples(13 239 specimens).300 pathogenic bacteria were detected,with a positive rate of 31.5%.Among them,13 fragrant bacteria were isolated,accounting for 4.3% of the positive specimens.The source of specimens were all detained urinary catheter specimens from critically ill patients.The drug sensitivity results showed that only tetracyclines were sensitive to them.Many other antibiotics were highly resistant.Conclusion The isolation rate and drug resistance rate of Aromatic bacteria in urine specimens of critical catheterization patients in this grass-roots hospital were high,which should be paid great attention to in clinic.The pathogenicity and clinical significance of aromatic bacteria should be analyzed scientifically and reasonably,and the accurate diagnosis and treatment should be strived for,and reduce the abuse of antibiotics.
Objective To retrospectively analyze the clinical laboratory characteristics and drug resistance of Aromatic bacteria isolated from urine in primary hospitals,so as to provide basis for precise clinical treatment and reduce the abuse of antibiotics.Methods Quantitative culture,identification and drug susceptibility analysis of urine culture specimens of inpatients from January to December 2018 were carried out by full automatic VITEK 2 compact and kit reagents from Meriere,France.Results 953 urine culture specimens were sent to inpatients in 2018,accounting for 7.20% of all microbial samples(13 239 specimens).300 pathogenic bacteria were detected,with a positive rate of 31.5%.Among them,13 fragrant bacteria were isolated,accounting for 4.3% of the positive specimens.The source of specimens were all detained urinary catheter specimens from critically ill patients.The drug sensitivity results showed that only tetracyclines were sensitive to them.Many other antibiotics were highly resistant.Conclusion The isolation rate and drug resistance rate of Aromatic bacteria in urine specimens of critical catheterization patients in this grass-roots hospital were high,which should be paid great attention to in clinic.The pathogenicity and clinical significance of aromatic bacteria should be analyzed scientifically and reasonably,and the accurate diagnosis and treatment should be strived for,and reduce the abuse of antibiotics.
引文
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[7] SPANIK S,TRUPL J,KRCMERY V.Nosocomial catheter-associated Flavobacterium odoratum bacteraemia in cancer patients[J].Journal of Medical Microbiology,1998,47(2):183.
[8] JACOBS A,CHENIA H Y.Biofilm-forming capacity,surface hydrophobicity and aggregation characteristics of Myroides odoratus isolated from south afriean oreoehromis mossambicus fish[J].J Appl Microbiol,2009,107(6):1957-1966.
[9] DHAM M S,GUPTA A K,RANGREZ A Y,et al.Antibacterial activities of multi drug resistant Myroides odoratimimus bacteria isolated from adult flesh flies(Diptera:sarcophagidae) are independent of metallo beta-lactamase gene[J].Braz J Microbiol,2008,39(2):397-404.
[10] AHMAD S,KHAN Z,MUSTAFA A S.et al.Epidemiology of Candida colonization in an intensive care unit of a teaching hospital in Kuwait[J].Med Mycol,2003,41(6):487-493.
[11] 陈杏春,梁亮,林伟.尿培养芳香黄杆菌11例分析[J].实用医技杂志,2009,16(9):691-692.CHEN Xingchun,LIANG Liang,LIN Wei.Analysis on the flavobacterium odoratum bacteriuria from 11 urine samples[J].Journal of Practical Medical Techniques,2009,16(9):691-692.
[12] HU Shaohua,YUAN Shuxing,QU Hai,et al.Antibiotic resistance mechanisms of Myroide ssp[J].Journal of Zhejiang University Sciences,2016,17(3):188-199.
[13] KTARI S,MNIF B,KOUBAA M,et al.Nosocomial outbreak of Myroides odoratimimus.urinary tract infection in a tunisian hospital[J].Journal of Hospital Infection,2012,80(1):77-81.
[2] KIM D S,PAEK J,SHIN J H,et al.Genome sequence of Myroides injenensis M09-0166(T),isolated from clinical specimens[J].J Bacteriol,2012,194(10):2748-2749.
[3] 尚红,王毓三,申子瑜.全国临床检验操作规程[S].4版.北京:人民卫生出版社,2015:322-324.SHANG Hong,WANG Yusan,SHEN Ziyu.National guide to clinical laboratory procedures[S].4th Ed.Beijing:People’s Medical Publishing House,2015:322-324.
[4] BENEDETTI P,RASSU M,PAVAN G,et al.Septic shock,pneumonia,and soft tissue infection due to Myroides odoratimimus:report of a ease and review of Mroides infections[J].Infection,2011,39(2):161-165.
[5] 刘婧娴,余静,陈峰,等.一株香味类香味菌碳青霉烯酶基因及其感染的临床治疗研究[J].中华临床感染病杂志,2015,8(1):53-57.LIU Jingxian,YU Jing,CHEN Feng,et al.Study of carbapenem-resistant genes in a strain of Myroides odoratimimus and clinical therapy for its infection[J].Chinese Journal of Clinical Infectious Diseases,2015,8(1):53-57.
[6] 解春宝,罗江蓉,喻华,等.香味菌临床分离株耐药谱分析[J].中国微生态学杂志,2014,26(9):1092-1093.XIE Chunbao,LUO Jiangrong,YU Hua,et al.The drug resistance spectrum of clinically isolated Myroides SPP[J].Chinese Journal of Microecology,2014,26(9):1092-1093.
[7] SPANIK S,TRUPL J,KRCMERY V.Nosocomial catheter-associated Flavobacterium odoratum bacteraemia in cancer patients[J].Journal of Medical Microbiology,1998,47(2):183.
[8] JACOBS A,CHENIA H Y.Biofilm-forming capacity,surface hydrophobicity and aggregation characteristics of Myroides odoratus isolated from south afriean oreoehromis mossambicus fish[J].J Appl Microbiol,2009,107(6):1957-1966.
[9] DHAM M S,GUPTA A K,RANGREZ A Y,et al.Antibacterial activities of multi drug resistant Myroides odoratimimus bacteria isolated from adult flesh flies(Diptera:sarcophagidae) are independent of metallo beta-lactamase gene[J].Braz J Microbiol,2008,39(2):397-404.
[10] AHMAD S,KHAN Z,MUSTAFA A S.et al.Epidemiology of Candida colonization in an intensive care unit of a teaching hospital in Kuwait[J].Med Mycol,2003,41(6):487-493.
[11] 陈杏春,梁亮,林伟.尿培养芳香黄杆菌11例分析[J].实用医技杂志,2009,16(9):691-692.CHEN Xingchun,LIANG Liang,LIN Wei.Analysis on the flavobacterium odoratum bacteriuria from 11 urine samples[J].Journal of Practical Medical Techniques,2009,16(9):691-692.
[12] HU Shaohua,YUAN Shuxing,QU Hai,et al.Antibiotic resistance mechanisms of Myroide ssp[J].Journal of Zhejiang University Sciences,2016,17(3):188-199.
[13] KTARI S,MNIF B,KOUBAA M,et al.Nosocomial outbreak of Myroides odoratimimus.urinary tract infection in a tunisian hospital[J].Journal of Hospital Infection,2012,80(1):77-81.