137例儿童急性下呼吸道感染流感嗜血杆菌耐药性分析

Antibiotic resistance analysis in 137 strains of Haemophilus influenzae isolated from children with acute lower respiratory tract infection

目的了解我院2004年1月至2006年8月急性细菌性下呼吸道感染(ALRTI)患儿痰中分离的137株流感嗜血杆菌(Hi)耐药性及产酶率。方法用ATB药敏鉴定条对痰液中分离的137株Hi做药敏试验及β内酰胺酶测定。结果小于3岁组儿童Hi117株,占85.4%;对氨苄西林耐药43株,耐药率为31.4%;产β内酰胺酶25株,产酶率18.2%;耐药主要集中在氨苄西林、红霉素、利福平、复方磺胺甲噁唑和苯唑西林,且多重耐药91株,占66.4%。结论Hi是引起儿童ALRTI的常见病原菌,多见3岁以下儿童,对红霉素、复方磺胺甲噁唑、利福平和氨苄西林的耐药率较高,本研究结果为合理选用抗菌药物提供依据。

Objective To understand the antibiotic resistance and beta lactamase production in 137 strains of H. influenzae isolated from the sputum of children with acute lower respiratory tract infection. Methods The sputum of children with acute lower respiratory tract infection was cultured to isolate H. influenzae. The H. influenzae isolates were tested for the production of beta-lactamase. Results Most H. influenzae （77 = 117, 85. 4%） were isolated from children under 3 years old. Forty three strains （31.4%） were resistant to ampicillin. Beta-lactamase production was positive in 25 strains （18.2%）. The isolated H. influenzae strains were mainly resistant to ampicillin, erythromycin, rifampin, SMZ-TMP and oxacillin. Multi-drug resistance was found in 91 strains （66.4%）. Conclusions H. influenzae is the common pathogen of acute lower respiratory tract infection in children, especially those under 3 years old. H. influenzae is relatively resistant to erythromycin, SMZ-TMP, rifampicin and ampicillin. The results of present study will inform future rational antibacterial therapy.