重症监护病房脑膜脓毒金黄杆菌医院感染的调查分析

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 meningosepticum）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。

Chryseobacterium meningosepticum infection in intensive care units:an analysis and survey

Objective To understand the clinical characteristics and resistance of Chryseobacterium meningosepticum infection in order to provide evidence for clinical rational drug utilization. Method 47 cases of clinical infections with C. meningosepticum from Jan 2007 to Dec 2008 were performed retrospective analysis. Result 45 cases （95.7%） had critical underlying diseases, the common correlative factor of infection by C. meningosepticum. Other infection-associated factors included invasive operation, environment pollution, central venous catheter and long-term use of broad-spectrum antimicrobial drugs. Metallo-13-1actamases-producing strains accounted for 100% in all C. meningosepticum isolates. C. meningosepticum were susceptible or partly susceptible to vancomycin （ 100% ）, cefoperazone/sulbactam （ 83.0% ）, piperacil- lin/tazobactam （57.1%）, ticarcillin/clavulanate （52.4%）, TMP/SMZ （45.2%）. The susceptibility to other antimicrobials tested were within 6.4% - 0. Conclusion Decreasing days in hospital, reducing invasive operation and using antibi- otics rationally may decrease the risk of infection by C. meningosepticum. Vancomycin, cefoperazone/sulbactam, piperacillin/tazobactam, ticareillin/clavulanate and TMP/SMZ are the effective antibiotics against C. meningosepticum.