Clinical distribution and drug resistance analysis of Stenostomonas maltophilia
WANG Shibo1 GAO Yanjun2 SHI Like1 LI Jihong1 WANG Yue1 DONG Xing1 WANG Liyi1 JIA Yuan1
1.Department of Infection Management, the Second Hospital of Hebei Medical University, Hebei Province, Shijiazhuang 050000, China;
2.Clinical Laboratory, Hebei Chest Hospital, Hebei Province, Shijiazhuang 050041, China
Abstract:Objective To analyze the clinical distribution and resistance of Stenotrophomonas maltophilia. Methods Stenotrophomonas maltophilia was isolated from hospitalized patients in the Second Hospital of Hebei Medical University from January 2019 to December 2021, and the clinical distribution, specimen sources, and drug sensitivity tests of stenotrophomonas maltophilia were retrospectively analyzed through WHONET 5.6 system. Results A total of 966 strains of Stenotrophomonas maltophilia were isolated from January 2019 to December 2021, and the detection rate of gram-negative bacilli was 2.54%. The department with the highest detection rate was pediatric internal medicine. The proportion of Stenotrophomonas maltophilia in respiratory department was the highest (30.85%). The majority of patients with Stenotrophomonas maltophilia infection were elderly patients over 60 years old, accounting for 57.04%. A total of 771 strains of Stenotrophomonas maltophilia were isolated from sputum specimens, accounting for 79.81%. The drug susceptibility test results showed that the drug resistance rates of Stenotrophomonas maltophilia to Minocycline, Cotrimoxazole, and Levofloxacin were 2.60%, 10.40% and 13.50%, respectively; the drug resistance rate to ceftazidime was 70.9%. The drug susceptibility results of Stenotrophomonas maltophilia from different samples showed that the drug resistance rates of stenotrophomonas maltophilia in lavage fluid, urine and blood samples were higher than those in sputum samples to Minocycline, Cotrimoxazole, Levofloxacin, and Ceftazidime. Conclusion Stenotrophomonas maltophilia mainly came from respiratory department, mainly sputum. The susceptible population is the elderly with high drug resistance. Clinicians should reasonably select antibiotics according to the results of drug sensitivity to reduce the generation and prevalence of drug-resistant strains.
王世博1 高艳军2 史利克1 李继红1 王悦1 董星1 王黎一1 贾媛1. 嗜麦芽窄食单胞菌的临床分布及耐药性分析[J]. 中国医药导报, 2023, 20(13): 161-165.
WANG Shibo1 GAO Yanjun2 SHI Like1 LI Jihong1 WANG Yue1 DONG Xing1 WANG Liyi1 JIA Yuan1. Clinical distribution and drug resistance analysis of Stenostomonas maltophilia. 中国医药导报, 2023, 20(13): 161-165.
[1] Klimkaite L,Armalyte J,Skerniskyte J,et al. The Toxin-Antitoxin Systems of the Opportunistic Pathogen Stenotrop- homonas maltophilia of Environmental and Clinical Origin [J]. Toxins (Basel),2020,12(10):635.
[2] Trifonova A,Strateva T. Stenotrophomonas maltophilia-alow- grade pathogen with numerous virulence factors [J]. Infect Dis (Lond),2019,51(3):168-178.
[3] Maria MF,Humphries R,Lipuma JJ,et al. Clinical challenges treating Stenotrophomonas maltophilia infections:an update [J]. JAC Antimicrob Resist,2022,4(3):dlac040.
[4] Isom CM,Fort B,Anderson GG. Evaluating Metabolic Pathways and Biofilm Formation in Stenotrophomonas maltophilia [J]. J Bacteriol,2022,204(1):e0039821.
[5] Prates M,Fernandes F,Proen?觭a F,et al. Oral Infection Caused by Stenotrophomonas maltophilia:A Rare Presentation of an Emerging Opportunistic Pathogen [J]. Case Rep Infec Dis,2020,2020:6346120.
[6] Majumdar R,Karthikeyan H,Senthilnathan V,et al. Review on Stenotrophomonas maltophilia:An Emerging Multidrug- resistant Opportunistic Pathogen [J]. Recent Pat Biotechnol,2022,16(4):329-354.
[7] 胡付品,郭燕,朱德妹,等.2016年中国CHINET细菌耐药性监测[J].中国感染与化疗杂志,2017,17(5):481-491.
[8] Varshini MK,Ganesan V,Sundaramurthy R,et al. Risk Factors and Clinical Outcomes of Stenotrophomonas maltophilia Infections:Scenario in a Tertiary Care Center from South IndiaIndian [J]. J Crit Care Med,2022,26(8):935-937.
[9] Jones BM,Wagner JL,Chastain DB,et al. Real-world, multicentre evaluation of the incidence and risk factors for non-susceptible Stenotrophomonas maltophilia isolates [J]. J Glob Antimicrob Resist,2022,28:282-287.
[10] Bao H,Qiao Y,Liu D,et al. The clinical impact of Steno- trophomonas maltophilia bacteremia on the 30-day mortality rate in patients with hematologic disorders: a single-institution experience [J]. Infection,2020,48(2):205-212.
[11] Wang N,Tang C,Wang L. Risk Factors for Acquired Sten- otrophomonas maltophilia Pneumonia in Intensive Care Unit:A Systematic Review and Meta-Analysis [J]. Front Med (Lausanne),2022,8:8808391.
[12] Jian J,Xie Z,Chen L. Risk Facors for Mortality in Hospitalized Patients with Stenotrophomonas maltophilia Bacteremia [J]. Infect Drug Resist,2022,15:3881-3886.
[13] Kanchanasuwan S,Rongmuang J,Siripaitoon P, et al. Clinical Characteristics,Outcomes,and Risk Factors for Mortality in Patients with Stenotrophomonas maltophilia Bacteremia [J]. J Clin Med,2022,11(11):3085.
[14] 张宇豪,马晨城,王明汉,等.安徽省859株嗜麦芽窄食单胞菌临床感染特征及耐药性分析[J].国际流行病学传染病学杂志,2021,48(1):33-37.
[15] 熊丽蓉,冯伟,向荣凤,等.我院2005-2017年嗜麦芽窄食单胞菌的临床分布及耐药性分析[J].中国药房,2018, 29 (16):2248-2251.
[16] 吕刚飞,刘海洋,赵乔妹.山东地区医院获得性嗜麦寡养食单胞菌的耐药性及感染相关危险因素分析[J].现代检验医学杂志,2018,33 (3) :136-140.
[17] Tamma PD,Aitken SL,Bonomo RA,et al. Infectious Diseases Society of America Guidance on the Treatment of AmpC β-Lactamase-Producing Enterobacterales,Carbapenem-Resistant Acinetobacter baumannii,and Stenotr- ophomonas maltophilia Infections [J]. Clin Infect Dis,2022, 74(12):2089-2114.
[18] Kadri SS,Lai YL,Warner S,et al. Inappropriate empirical antibiotic therapy for bloodstream infections based on discordant in-vitro susceptibilities: a retrospective cohort analysis of prevalence, predictors, and mortality risk in US hospitals [J]. Lancet Infect Dis,2021,21(2):241-251.
[19] O’Donnell JN,Putra V,Lodise TP. Treatment of patients with serious infections due to carbapenem-resistant Acinetobacter baumannii: how viable are the current options? [J]. Pharmacotherapy,2021,41(9):762-780.
[20] Karaba SM,Goodman KE,Amoah J,et al. StenoSCORE:predicting Stenotrophomonas maltophilia bloodstream infections in the hematologic malignancy population [J]. Antimicrob Agents Chemother,2021,65(8):e0079321.
[21] Kullar R,Wenzler E,Alexander J,et al. Overcoming Stenotrophomonas maltophilia Resistance for a More Rational Therapeutic Approach [J]. Open Forum Infect Dis,2022, 9(5):ofac095.
[22] 韦永先,别宁凡.嗜麦寡养食单胞菌耐药机制研究综述[J].临床合理用药,2019,12(1A):172-174.
[23] 蒙光义,王冬晓,彭评志.嗜麦芽窄食单胞菌临床感染与治疗的研究进展[J].西北药学杂志,2020,35(4):618-623.
[24] 张曼佳.2017~2019年某院脓毒血症患者原菌菌种鉴定及药敏试验结果分析[J].中国当代医药,2021,28(17):199-202.
[25] 尉景娟,马立艳,苏建荣.替加环素对嗜麦芽窄食单胞菌体外药物敏感检测方法的比较[J].临床和实验医学杂志,2021,20(12):1340-1343.
[26] Gil-Gil T,Martinez JL,Blanco P. Mechanisms of antimicrobial resistance in Stenotrophomonas maltophilia:a review of current knowledge [J]. Expert Rev Anti Infect Ther,2020,18(4):335-347.
[27] 蔺晓萱,谢立新,霍炳杰.嗜麦芽窄食单胞菌耐药机制及治疗策略的研究[J].河北医科大学学报,2020,41(9):1112-1116.
[28] 杨雪飞,汪德珍,张俊,等.粒细胞缺乏症伴感染患者致病菌种类及耐药性分析[J].中国医药导报,2021,18(20):104-107.