| Objective:To investigate infection the clinical distribution, clinical characteristics, risk factors and drug sensitivity of Burkholderia cepacia (BC) infection so as to lay a scientific foundation for reasonable clinical application of antibiotics.Methods:VITEK-32 automatic bacteria analysis system was applied in this research to detect the BC collected from various specimen in People's Hospital of Jilin Province during the period from to October 2004 to November 2010. GNI+ card matched this system was used to test BC drug sensitivity so as to retrospective analysis could be conducted for patients infected with BC.Results:1.67 strains of BC were separated from the clinically delivered specimen during the period of October 2004 to November 2010.The distribution was as following:2 cases in 2004(2.99%),3 cases in 2005(4.48%),9 cases in 2006(13.43%),10 cases in 2007(14.93%),12 cases in 2008(17.91%),14 cases in 2009(20.90%) and 17 cases in 2010(25.37%).2. The infection cases mainly distributed in Respiratory Department (24 cases, accounting for 35.83% of total) and ICU (9 cases, accounting for 13.43%of total).3.51 cases was from sputum sample(76.12%),6 cases from blood sample(8.96%),4 cases from throat swab sample(5.97%),3 cases from urine(4.48%),2 cases from wound surface(2.96%) and 1 case from abdominal dropsy(1.49%).4.44 cases comes from male patients(65.67%) and 23 cases from female patients(34.33%). Patients age ranged from 17-96 years old, averaging age 64 years old.44 patients(65.67%) were older than 60 years old. Length of stay ranged from 4-134 days, averaging 46 days and 57 patients(85.07%) stayed in hospital for more than 14 days.5.20 patients(29.85%) were healthy before hospitalized, while 47 patients(70.15%) suffered from foundation illness and 38 patients(56.72%) had more than 2 sorts of foundation diseases.6. There was no specific clinical manifestation in BC infection patients.56 patients had fever(83.58%),43 patients(64.18%) had cough,expectoration.14 patients(20.90%) suffered from severe anhelation,3 patients(4.48%) suffered from frequent micturition, urgency and urinary tract burning sensation, and 10 patients (14.93%) combined pleural effusion.7. Pure BC strain was cultured in only 19 patients and more than 2 strain pathogene bacteria were separated from 48 patients(71.64%).15 patients(22.34%) combined fungous infection.8.56 patients(83.58%) underwent invasive diagnostic or treatment during hospital stay.9. BC was not sensitive to most antibiotics. The drugs sensitive to BC included ciprofloxacin(61%), imipenem(58%), trimethoprim/sulfamethoxazole (49%), minocycline(49%), meropenem (48%), cefoperazone and sulbactam (48%). BC was much more resist to cefazolin (94%), amikacin(70%) and gentamicin (61%).10.18 patients(26.87%) died,41 patients(61.19%) improved and discharged.Conclusions:1. BC infection in clinics is rising up every year.2. It can be found in any clinical department, respiratory system is vulnerable to BC infection, and The is no specific characteristics in clinical manifestation.3. High risk factor for BC infection includes old age, long hospital stay, complexed basic diseases, ICU stay, immune function depression,invasive diagnosis or treatment, long period broad-spectrum antibiotics usage, glucocorticoid and immune depressant application.4. BC is naturally resistant to most antibiotics. Clinical treatment for BC infection should be based on vitro drug sensitivity test. trimethoprim/sulfamethoxazole, minocycline, ciprofloxacin, imipenem,meropenem and cefoperazone and sulbactam can be empirically applied, and combined drug usage should be considered. Aminoglycosides drugs such as amikacin and cidomycin should not be applied. We should emphasize the importance of pathogen detection, and as far as possible to prevent Empirical therapy. |
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