48株流感嗜血菌的分离培养与耐药性分析

Culture,isolation and antimicrobial resistance of haemophilus influenzae 48 strains

目的调查临床呼吸道送检标本的流感嗜血菌分离率及其对7种常用抗菌药物的耐药率,为临床抗感染治疗提供实验室依据。方法回顾性分析837例临床呼吸道标本中的流感嗜血菌分离率,并采用K-B琼脂扩散法测定分离菌株的药物敏感性。结果共分离出48株流感嗜血菌,平均分离率为5.73%,其中住院患者分离率为4.76%,门诊患者分离率为12.75%;48株菌中,产β-内酰胺酶6株,阳性率为12.50%;对7种常用抗菌药物的敏感性测试结果显示,磺胺甲噁唑/甲氧苄啶耐药率为52.08%、氨苄西林的耐药率为14.58%、阿奇霉素、左氧氟沙星、头孢曲松的耐药率分别为16.67%、16.67%、8.33%、对亚胺培南和头孢哌酮/舒巴坦的耐药率为0。结论门诊患者标本的流感嗜血菌分离率明显高于住院患者标本分离率,流感嗜血菌除对磺胺类抗菌药物有很高的耐药率外,氨苄青霉素、左氧氟沙星、阿奇霉素可作为有效用药。

OBJECTIVE To investigate the isolation rate and the antimicrobial resistance of Haemophilus influenzae from clinical specimens of respiratory tract to seven common antibiotics.METHODS The isolation rates of H.influenzae of 837 specimens were retrospectively analyzed.The antimicrobial susceptibility patterns was determined by using K-B methods and interrupted according to CLSI guideline.RESULTS A total of 48 strains of H.influenzae were isolated with the average isolation rate of 5.73%,among which,the isolation rate of the inpatients was 5.73% and the outpatients was with 12.75%,beta-lactamase production（12.50%） was the main mechanism of ampicillin resistance.Resistance to SMZ was 52.08%,followed by resistance to azithrocymin（16.67%）,levofloxacin（16.67%）,ampcillin（14.58%）,and ceftriaxone（8.33%）.All isolates were susceptible to imipenem and cefoperazone/sulbactam.CONCLUSION The isolation rate of H.influenzae isolated from specimens of outpatients is remarkably higher than that of the inpatients.The study suggests that ampcillin,azithrocymin and levofloxacin are still the first choice to treat the infection of respiratory tract caused by H.influenzae.