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目的通过对重症监护病房(Intensive Care Unit,ICU)内脑膜脓毒金黄杆菌(Chryseobacterium menin-gosepticum)医院感染的临床特征和耐药性调查分析,为临床更好地预防和治疗该细菌所引起的感染提供参考。方法对我院2007年1月至2008年12月重症监护病房脑膜脓毒金黄杆菌医院感染的47例患者进行回顾性调查。结果45例(95.7%)患者均有严重的基础疾病,与感染相关的因素还包括侵入性操作、深静脉置管、环境污染及长期广谱抗菌药物的应用;47株脑膜脓毒金黄杆菌全部检测出金属β-内酰胺酶,具多重耐药性。体外抗菌活性较好的抗菌药物依次为万古霉素(100.0%)、头孢哌酮/舒巴坦(83.0%)、哌拉西林/他唑巴坦(57.1%)、替卡西林/克拉维酸(52.4%)和复方新诺明(45.2%),其余所检测的抗菌药物体外抗菌活性均在6.4%~0。结论缩短住院时间、加强病区环境和空气监控、尽量减少侵入性操作和合理使用抗生素是减少脑膜脓毒金黄杆菌感染发生的重要措施。治疗脑膜脓毒金黄杆菌,可选用万古霉素、头孢哌酮/舒巴坦、哌拉西林/他唑巴坦、替卡西林/克拉维酸和复方新诺明。
Objective To investigate the clinical characteristics and drug resistance of hospital infection of Chryseobacterium menin-gosepticum in Intensive Care Unit (ICU) in order to better prevent and treat this bacterium in clinic Infections provide a reference. Methods Retrospective investigation was performed on 47 hospital patients with N. meningitidis serogroup F hospital infection from January 2007 to December 2008 in our hospital. Results All the 45 patients (95.7%) had serious underlying diseases. Infection-related factors included invasive procedures, catheterization of deep veins, environmental pollution and long-term use of broad-spectrum antimicrobial drugs. All 47 strains of N. meningitidis Detection of metal β-lactamase, with multiple drug resistance. The best antimicrobial agents in vitro were vancomycin (100.0%), cefoperazone / sulbactam (83.0%), piperacillin / tazobactam (57.1%), ticarcillin / clavulanic acid (52.4%) and cotrimoxazole (45.2%). The antibacterial activity of the other tested antibiotics was 6.4% ~ 0 in vitro. Conclusions Shortening hospital stay, strengthening ward environment and air monitoring, minimizing invasive procedures and rational use of antibiotics are important measures to reduce the incidence of N. meningitidis infection. For the treatment of meningococcal meningitis, vancomycin, cefoperazone / sulbactam, piperacillin / tazobactam, ticarcillin / clavulanic acid and cotrimoxazole may be used.