老年患者呼吸道嗜血杆菌的分离及耐药性分析

Isolation identification and drug resistance analysis of Haemophilus in the elderly with respiratory tract infection

目的 了解老年呼吸道嗜血杆菌的分离、鉴定及其β-内酰胺酶的产生率和耐药性.方法 采用自配的专用嗜血杆菌培养基分离细菌,在血琼脂平板和M-H平板上做卫星试验对分离出的细菌进行鉴定,阳性者部分用NHI卡进行确认.用头孢硝噻吩法测试β-内酰胺酶的产酶率,并用琼脂扩散法进行药敏试验.结果 1 138份标本共检出119株嗜血杆菌,检出率10.5%,其中流感嗜血杆菌25株（21.0%）,副流感嗜血杆菌94（79. 0% ）株,嗜血杆菌β-内酰胺酶的产生率为23.5%;左氧氟沙星、氨苄西林、复方新诺明对嗜血杆菌的耐药率较高,为15.0%～54.6% （流感嗜血杆菌）、19.2%～56.5%（副流感嗜血杆菌）;而阿莫西林/克拉维酸、氨曲南和二代三代头孢对嗜血杆菌的耐药率则较低（均＜10 %）.结论分离出的嗜血杆菌主要以副流感嗜血杆菌为主,对阿莫西林 /克拉维酸、氨曲南和二代三代头孢菌素的敏感性高于其他抗生素,可作为首选治疗用药.

Objective To investigate the isolation,identification and susceptibihty of Haemophilus, and the produce rate of β-1actamases in the elderly with respiratory tract infection. Methods Haemophilus isolated by a special haemophilus culture medium was identified by sat- ellites in sheep blood agar and Mueller-Hinton agar. The positive results of both were eontirmed by NHI card. The producing rate of β-1actamases was examined by eephalosporin 87/312. The agar diffusion method was used to determine the susceptibility. Results Of one hundred and nineteen strains of haemophilus isolated from 1 138 specimens,the detected rate accounting for 10. 5% ,there were 25 strains of haemophilus influenzac（21.0% ） and 94 haemophilus parainfluenzac （79. 0% ）. The haemophilus β-1actamases producing rate was 23.5%. The rate of drug resistance was higher to levofloxacin,ampieiUin and baetrim,reaching 15.0% to 54. 6% in haemophilus influenzac,and 19. 2% to 56. 5% in haemophilus parainfluenzac, but was lower to amoxieiUin/elavulanie acid, aztreonam and the second and third generation cephalosporins, all below 10%, Conclusions The isolated haemophilus parainfluenzae are the major form of respiratory tract infection. The susceptibility of amoxicillin/ elavulanie acid,aztreonam and the second and third generation eephalosporins is higher than that of the other and could be of choice.