慢性阻塞性肺疾病中的流感嗜血杆菌感染

Respiratory infection to Haemophilus influenzae in chronic obstructive pulmonary disease

目的：了解上海地区慢性阻塞性肺疾病（ Ｃ Ｏ Ｐ Ｄ）中流感嗜血杆菌（ Ｈ Ｉ）感染的发病情况、药物敏感性及临床特点。方法：以改良哥伦比亚巧克力琼脂作为分离培养基，分别以纸片（ Ｋ Ｂ）法和肉汤微量稀释法测定各种抗生素的敏感性，分析 Ｃ Ｏ Ｐ Ｄ患者 Ｈ Ｉ感染的临床特点。结果：在４２１ 例 Ｃ Ｏ Ｐ Ｄ急性加重的患者中，分离出致病菌２２９ 株，其中４５ 株（１９．７％ ）为 Ｈ Ｉ；患者临床表现主要为肺部一般炎症；第３ 代头孢菌素和喹诺酮类抗生素抗菌活性高，氨苄西林的耐药率达 ２２．２％ 。结论： Ｈ Ｉ感染是 Ｃ Ｏ Ｐ Ｄ急性加重的主要原因之一，其临床特点无特异性。喹诺酮类、第３ 代头孢菌素等抗生素对 Ｈ Ｉ抗菌活性较高。

Objective:To study the incidence, the antibiotics sensitivity and clinical characteristics of respiratory infection to H. influenzae in chronic obstructive pulmonary disease (COPD). Methods: Improved Columbia chocolate agar was used for the primary isolation of H. influenzae from sputums. The sensitivities of 20 antibiotics to H. influenzae were determined in vitro by Kirby Bauer method and MICs of 12 antibiotics were determined by broth microdilution method. The clinical characteristics of respiratory infection to H. influenzae in COPD patients were analyzed. Results: Among 421 cases of COPD with acute acceleration, 229 strains of bacterium were isolated, 45(19.7%) were H. influenzae. The third generation of cephalosporins and the quinotones were most active against H. influenzae. The resistant rate against H. influenzae of Ampicillin was 22.2%.Conclusion:The infection due to H. influenzae is one of the most important agents leading to acute acceleration in COPD. The clinical characteristics of respiratory infection due to H. influenzae in COPD are no special.