张妍琴　杨华梁

湖南省邵阳市中医医院检验科，湖南邵阳422000

肿瘤患者嗜麦芽窄食单胞菌分布及耐药性分析

张妍琴杨华梁

湖南省邵阳市中医医院检验科，湖南邵阳422000

目的了解肿瘤患者分离嗜麦芽窄食单胞菌（SMA）的分布及耐药情况，为临床合理、科学使用抗菌药物预防和控制感染提供实验依据。方法收集我院肿瘤专科2014年4月1日～2015年3月31日各类临床标本分离的SMA 115株，并检测SMA对常用的6种抗菌药物的敏感性。结果115株SMA分离自痰、支气管灌洗液96株，尿液8株，血液5株，伤口分泌物4株，胸腹水2株。SMA对复方新诺明、米诺环素的耐药率为1%；对头孢他啶、哌拉西林/他唑巴坦、左旋氧氟沙星、头孢哌酮/舒巴坦、的耐药率依次为49%、41%、12%、8%。结论SMA对哌拉西林/他唑巴坦、头孢他啶的耐药率较高；对复方新诺明、米诺环素的耐药率很低；对头孢哌酮/舒巴坦、左旋氧氟沙星的敏感率也保持在较高水平，临床应根据药敏结果选择用药。

嗜麦芽窄食单胞菌；肿瘤患者；耐药率；敏感率

［Abstract］Objective To understand the distribution and drug resistance of isolated stenotrophomonas maltophilia（SMA）in patients with tumor and provide experimental evidence for the reasonable and scientific application of antibacterial agents to prevent and control the infection.Methods 115 strains of SMA isolated from various clinical samples of the Department of Oncology of our hospital were collected from April 1st，2014 to March 31st，2015 and the sensitivity of SMA to the 6 commonly-used antibacterial agents was measured.Results Among the 115 strains，96 strains were isolated from the sputum and bronchial lavage fluids，8 strains from the urine，5 strains from the blood，4 strains from the wound secretion and 2 strains from the pleural effusion and ascites.The drug resistance of SMA to cotrimoxazole and minocycline was 1%；the drug resistance to ceftazidime，piperacillin/tazobactam，levofloxacin and cefoperazone/sulbactam was respectively 49%，41%，12%and 8%.Conclusion The drug resistance of SMA to piperacillin/ tazobactam and ceftazidime was relatively high，while the resistance to cotrimoxazole and minocycline was very low；the sensitivity of SMA to cefoperazone/sulbactam and levofloxacin was also in high level，therefore，the clinical medication should be based on the results of drug sensitivity.

［Key words］Stenotrophomonas maltophilia；Patients with tumor；Drug resistance；Sensitivity

嗜麦芽窄食单胞菌（stenotrophomonas maltophilia，SMA）是临床常见的条件致病菌之一，也是近年引发医院感染频率较高的细菌［1］，可引起机体多个部位、多个系统和多个脏器的感染。近年来，随着细菌耐药性的增加及碳青霉烯类药物的广泛应用，导致对该类药物天然耐药的SMA被选择出来；同时由于肿瘤患者免疫力低下，各种侵入性医疗操作和广谱抗菌药物、各种化疗药物和糖皮质激素等免疫抑制剂的使用，使这些患者在治疗过程中感染SMA。为指导临床科学、正确用药，本文现将我院2014年4月1日～2015年3月 31日分离的115株SMA的分布与耐药情况进行报道，并总结分析如下。……