2005年至2006年南京地区儿童流感嗜血杆菌耐药性分析

Antibiotic Resistance of Hemophilus Influenzae Isolated from Children in Nanjing area between 2005 and 2006

目的:研究我院2005年至2006年儿童感染流感嗜血杆菌(Hi)对常用抗生素的敏感性、产β-内酰氨酶情况,以有效指导临床合理用药和预防。方法:临床标本进行流感嗜血杆菌分离培养,用Kirbry-Bauer(K-B)法和Etest法测定203株流感嗜血杆菌对8种抗生素的耐药率,以Nitrocefin纸片法测定β-内酰氨酶。结果:流感嗜血杆菌β-内酰氨酶总产生率为44.83%;流感嗜血杆菌对头孢他啶、头孢噻肟、头孢曲松、美洛培南、氧氟沙星、阿奇霉素耐药率分别为7.87%、10.34%、7.39%、7.87%、2.96%和7.39%;对氨苄西林、复方磺胺甲基异噁唑的耐药率分别为49.75%和51.23%。结论:南京地区儿童呼吸道感染流感嗜血杆菌耐药形势严峻,与该地区前2年资料比较,流感嗜血杆菌对氨苄西林和复方新诺明耐药率明显升高,产β-内酰氨酶是流感嗜血杆菌对氨苄西林耐药的重要机制。对头孢他啶、头孢噻肟、头孢曲松、美洛培南、阿奇霉素有较高的敏感性。

Objective To investigate the situation of antibiotic resistance and β-lactamase Production of Hemophilus influenzae （Hi） clinical isolates from children in Naijing area. Methods The authors cultured, isolated and identified the Hi strains K-B disc difusion and E-test for antibiotic resistance were performed for these clinical isolate. Results The average rate of β- lactamase production among 203 strains of Hi was 44.83% （91/203）. For Hi isolates,the rates of resistance to ceftazidime,cefotaxime,ceftriaxone, meropenem, azithromycin, ampicilin, SMZ/TMP were 7.87%, 10. 34%, 7.39%, 7.87%, 2.96%, 7.39% ,49.75% ,and 51.23% ,respectively. Conclusion The antibiotic resistance Hi isolated from children in the area have become a severe problem. The rate of resistance to ampicilin, SMZ/TMP had been increased compared with the last two years. The mechanism of the antibiotic resistance to ampicilin is β-lactamase production of Hemophilus influenzae. The Hi isolated were more susceptible to the ceftazidime, cefotaxime ceftriaxone, meropenem, azithromycin.