中文摘要：

目的：分析神经重症监护室感染嗜麦芽窄食单胞菌患者耐药性及危险因素，为临床防治提供依据。方法回顾性分析合并下呼吸道嗜麦芽窄食单胞菌感染的42例神经重症患者的临床资料，并设为观察组；另84例未发生下呼吸道革兰氏阴性杆菌感染神经重症患者为对照组。对观察组下呼吸道的嗜麦芽窄食单胞菌标本进行药敏试验，通过单因素和多因素分析下呼吸道感染嗜麦芽窄食单胞菌的危险因素。结果药敏试验显示嗜麦芽窄食单胞菌对头孢哌酮/舒巴坦最为敏感（83.3%），对氨苄西林、头孢唑啉、头孢曲松及亚胺培南的耐药率达到100%。根据条件logistic回归分析的因素显示APACHE II评分（≥20）、抗生素应用的种类（〉3种）及有创呼吸机实用的天数（≥14 d）为神经重症患者下呼吸道感染嗜麦芽窄食单胞菌的独立危险因素。结论治疗嗜麦芽窄食单胞菌应选用头孢哌酮/舒巴坦等加酶抑制剂的敏感抗菌药物治疗。免疫抵抗力越低下，抗生素使用的种类越多及呼吸机支持时间越长，感染嗜麦芽窄食单胞菌的机会越大。

英文摘要：

Objective To analysis the antimicrobial drug-resistance and clinical risk factors of Stenotro-phomnas maltophilia （ SMA） in the neurological intensive care unit, so as to provide the basis for clinical prevention and treatment. Methods The clinical data of 42 cases of severe neurological with lower respiratory tract SMA infection were retrospectively analyzed （ observation group ）;84 cases of severe neurological pa-tients with no Gram-negative bacilli infection in lower respiratory tract served as a control. Drug sensitive test was examined on specimen of SMA in Observation group. Analysis the clinical risk factors of lower re-spiratory tract infection SMA through single factor and multiple factors analysis measures. Results Drug sen-sitive test shows that SMA is most sensitive to cefoperazone/sulbactam （83. 3%） and its drug resistance rate for ampicillin, cefazolin, ceftriaxone and imipenem can reach up to 100%. Condition logistic regression a-nalysis shows that APACHE II score（≥20）, types of antibiotics used（＆gt;3 kinds） and number of days the invasive breathing machine used （≥14 days） are independent risk factors to lower respiratory tract infection caused by SMA in critically-ill neurological patients. Conclusion Sensitive antibiotic drugs combined with enzyme inhibitors such as cefoperazone/sulbactam should be chosen for treatment of SMA. The lower im-mune resistance, the more types of antibiotics use and the longer time for application of the breathing ma-chine applied, the greater chances of SMA infections .