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目的探讨人苍白杆菌致外科重症患者感染的临床特点、危险因素与耐药性,为有效预防和控制感染提供指导。方法 2007年1月-2017年2月金华市3家医院细菌培养为人苍白杆菌34例外科重症患者作为感染组,50例同期未发生人苍白杆菌感染的外科重症患者作为对照组,比较分析引起该菌感染的危险因素。结果 34例人苍白杆菌感染者临床表现无特异,严重的基础疾病、侵入性操作和使用免疫抑制药物是引起感染的主要危险因素;该菌对青霉素类、含酶抑制剂、1代~3代头孢菌素类、其他β-内酰胺类等高度耐药,耐药率均高于90.0%,对氨基糖苷类、复方磺胺类、喹诺酮类、4代头孢菌素类头孢吡肟保持低度耐药,对四环素类、碳青酶烯类均不耐药。结论人苍白杆菌主要引起免疫力低下的肿瘤患者发生血流感染,临床应尽量减少不必要的侵入性操作,该菌对β-内酰胺类抗菌药物高度耐药,治疗该菌感染首选头孢吡肟、米诺环素、亚胺培南等耐药率较低的药物。
Objective To investigate the clinical features, risk factors and drug resistance of human infection caused by Corynebacterium parvum to provide guidance for effective prevention and control of infection. METHODS: From January 2007 to February 2017, 34 patients with severe C. argus in three hospitals in Jinhua City were selected as infection group and 50 severe critically ill patients without H. armigera infection as control group. Risk factors for bacterial infection. Results The clinical manifestations of 34 individuals infected with Corynebacterium parvum were nonspecific and serious underlying diseases. Invasive operation and immunosuppressive drugs were the main risk factors for infection. The strains were sensitive to penicillins, inhibitors containing enzymes, Cephalosporins, other β-lactams and other highly resistant, resistance rates were higher than 90.0%, for aminoglycosides, sulfamethoxazole compound, quinolones, fourth-generation cephalosporins cefepime low-resistance Drugs, tetracyclines, carbapenems are not resistant to drugs. Conclusion Corynebacterium parvum mainly causes bloodstream infection in patients with immunocompromised tumors. Clinically, it is necessary to minimize unnecessary invasive procedures. The bacterium is highly resistant to β-lactam antibiotics. For the treatment of bacterial infection, cefepime , Minocycline, imipenem and other drugs with lower drug resistance rate.