| Objective:To investigate the Burkholderia cepacia infection status and the antimicrobial resistance of Burkholderia cepacia by analyzing the clinical distribution and the ource, and to analyze the risk factor. of the Burkholderia cepacia infection. Probe the clinical characteristics of pulmonary infection to direct reasonable utilization of clinical antibacterials.Methods:Analyzing the antimicrobial resistance of 65 strains of Burkholderia cepacia to Minocycline, Trimethoprim+Sulfamethoxazole, Ceftazidime and Meropenem, from the Second hospital of shanxi medical university between Augest 2009 and September 2010. Patients' sexuality, age, severity of illness, length of hospitalization, number/types of indwelling catheters, concomitant infections and prior antibiotic exposure of 37 patients with positive cultures of Burkholderia cepacia isolated from respiratory tract,blood,urine and stool et.al were collected as a retrospective cohort study. Temperature, pressure, breathing rate, pulse, blood routine, hepatic function, blood gas analysis of the first day of positive culture of Burkholderia cepacia to assess severities of illness by the APACHEⅡ(acute physiology and chronic health evaluationⅡ) score. T test was used to determine the clinical significance of positive cultures of Burkholderia cepacia isolated from respiratory tract blood, urine and stool et.al, and approach effective factors of the outcomes.Results:Twenty-six males and eleven females were studied. The mean(SD) age was 60.38±18.66 years old, there were twenty-one patients whose age were over 50 years old,that was 78.38% of all of the studied patients.The mean (SD) length of hospitalization and it prior to positive cultures of Burkholderia cepacia were 40±22days and 18.78±13.01days respectively. The days of Prior to positive cultures of Burkholderia cepacia after incision of trachea or (and) tracheal intubation was 12.74±10.13days.Presence of underlying illness included hematological system disease 10 cases(27.03%), disease of respiratory system 11 cases(29.73%), disease of cardiovascular system 12 cases(32.43%). The sum was up to 89.19%. Types of indwelling catheters were various, including urinary catheters 22(59.46%),gastric tube 20(54.05%), incision of trachea or (and) tracheal intubation 18 (48.65%), central venous catheters 13(35.14%). Polymicrobial cultures (concurrent with Burkholderia cepacia were common and including fungus 15(44.11%), Acinetobacter baumannii 12(35.29%), Pseudomonas aeruginosa 4(11.76%), Klebsiella pneumonia, enterobacter cloacae, methicillin-resistant staphylococcus haemolyticus and Enterococcus Faecom were 2, respectively(36.36%). All patients had recepted the treatment with kinds of broad-spectrum antibiotics prior to positive culture of Burkholderia cepacia, including carbapenems 27(72.97%), third generation cephalosporins 23 (62.16%), anti-fungal agents 19(51.35%), anti-coccobacteria 18(48.65%), included linezolid, vancomycin et.al, penicillins withβ-lactamase inhibitors 10(27.03%), quinolones 8(21.62%).Turnover:26 patients improved while 10patients dead,1 patients given up. The ApacheⅡ(acute physiology and chronic health evaluationⅡ) score on the first day of positive culture of Burkholderia cepacia were 20±8.57. APACHEⅡscores that were over 20 were 10 patients,7 pateients were death, the death rate was 70%, APACHEⅡscores on the first day of positive culture of Burkholderia cepacia of 22 different prognostic patients were considered statistically significant(P<0.05). The antimicrobial resistant rate of Burkholderia cepacia to Minocycline, Trimethoprim+Sulfamethoxazole, Ceftazidime and Meropenem were 65.1%,79.4%,76.9%, 64.5%, respectively.Conclusion:①The susceptible population of Burkholderia cepacia infection was older person, especially older man. Lower respiratory tract was the most common position of Burkholderia cepacia infection, it also can cause blood, urinary and alimentary system infection. There was not distinguished characteristics in pulmonary infection of Burkholderia cepacia.②incision of trachea or (and) tracheal intubation, gastric tube detained, drugs of inhibiting gastric acid secretion, deep vein tube detained, length of using antibiotic drugs≥7days, using antibiotic drugs more than two types may be the risk factors for Burkholderia cepacia infection.③When APACHEⅡscores≥15,severity of illness has got worse, and mortality rate become higher.④Trimethoprim+Sulfamethoxazole and Ceftazidime are the optimal antibiotics of choice for the treatment of Burkholderia cepacia infections in our hospital. |
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