Analysis of the clinical distribution and drug resistance of Burkholderia gldioli / 新乡医学院学报

ABSTRACT

Objective To analyze the clinical distribution and drug resistance of Burkholderia gldioli,so as to provide epidemiological evidence for prevention and treatment of related diseases.Methods A total of 86 412 hospitalized patients in the First Affiliated Hospital of Xinxiang Medical University front January 2013 to November 2016 were selected as the subjects,including 81 807 patients who met the diagnostic criteria of bacteremia,and 4 605 patients who met the diagnostic criteria of meningitis.The blood,bone marrow and cerebrospinal fluid samples were collected for bacterial culture,strain identification and drug sensitivity test.The data were analyzed by WHONET 5.5 software.The carrying viral infection and the related inflammation markers including white blood cell count (WBC),C-reactive protein (CRP),erythrocyte sedimentation rate (ESR) and fibrinogen (FIB) were analyzed and summarized by Reimei software.Results There were 145 strains of Burkholderia gldioli were isolated from 86 412 patients,the isolating rate was 0.17％,and 122 cases were accompanied by basic diseases (84.14％).The isolating rate of blood specimens was the highest (0.17％).The isolating rate in mail was higher than that in female(0.22％ vs 0.10％),the isolating rate in the patients with more than 18 years old was higher than that in the patients with less than 18 years old (0.23％ vs 0.05％),the proportion was the highest in the department of infectious diseases (28.97％).In vitro drug sensitivity test showed that the resistance rate of Burkholderia gladioli to gentamicin,cefazolin,ampicillin,piperacillin,cotrimoxazole,aztreonam,amoxicillin clavulanic acid was more than 50％;the resistance rate of Burkholderia gladioli to aztreonam and amoxicillin clavulanic acid was 87.58％ and 80.00％ respectively;the proportion of multi drug resistant strains was 48.97％.The coincidence rate of Burkholderia gldioli and inflammatory markers was high (91.03％),and the carrying viral infection rate was 7.59％.Conclusion Attention should be paid to the bloodstream infections caused by Burkholderia gldioli,and the protection of patients with basic diseases should be strengthened.Because of the severe drug resistance situation,clinical diagnosis should be combined with inflammatory markers,and attention should be paid to patients with viral infection.Rational drug and drug combination should be selected according to drug sensitivity report.