57株流感嗜血杆菌的耐药性分析及分布

Resistance analysis and distribution of haemophilus influenzae bacillus

目的了解本院急性呼吸道感染患者临床分离出的流感嗜血杆菌的耐药性及菌株分布情况,为临床合理使用抗菌药物提供依据。方法采用法国梅里埃API NH鉴定条进行菌株鉴定,头孢硝噻吩检测菌株产β-内酰胺酶情况,纸片扩散法检测菌株的药敏情况。结果 2012年4月至2012年7月本院临床分离的57株流感嗜血杆菌中有38株对氨苄西林耐药,耐药率66.7%;29株β-内酰胺酶阳性,占50.9﹪;对复方新诺明、头孢呋辛、四环素、阿莫西林/克拉维酸和氯霉素的耐药率依次为82.5%(47/57)、22.8%(13/57)、15.8%(9/57)、12.3%(7/57)和8.8%(5/57),对头孢噻肟、美罗培南、左氧氟沙星和阿奇霉素均敏感。57株流感嗜血杆菌中有12株(21.1%)来源10岁以下患儿,4株(7.0%)来源于30～40岁的患者,41株(71.9%)来源于50岁以上的患者。结论流感嗜血杆菌对临床常用抗菌药物的耐药率相差很大,本院引起的呼吸道感染多见于老年和儿童患者,临床上应根据本院的流行特点合理选用抗菌药物。

Objective To study the resistance and distribution of Haemophilus influenzae isolated from patients with acute respiratory infections in our hospital, and provide a basis for rational use of antimicrobial agents. Method French Merieux APINH identification strips were used for strain identiifcation;β-lactamase of strains were detected by cephalosporin nitroceifn;Antibiotic susceptibility of strains were tested through the disk diffusion assay. Results Total of 57 strains of Haemophilus inlfuenzae were isolated during April 2012 to July 2012. There were 38 strains were resistant to ampicillin, with the resistance rate was 66.7%; 29 strains produced β-lactamase, accounting for 50.9%. The resistance rates to cotrimoxazole, cefuroxime, tetracycline, amoxicillin/clavulanic acid and chloramphenicol were 82.5%（47/57）, 22.8%（13/57）, 15.8%（9/57）, 12.3%（7/57） and 8.8%（5/57）, respectively. All of the strains were sensitive to cefotaxime, meropenem, levolfoxacin and azithromycin. Among the 57 strains of Haemophilus inlfuenzae, 12 （21.1%） strains were isolated from pediatric patients less than 10 years old, 4 strains were from patients between 30-40 years old, 41 （71.9%） strains were from patients more than 50 years old. Conclusions Resistance rates of Haemophilus inlfuenzae to common antimicrobial agents were vary widely. Respiratory tract infection caused by Haemophilus inlfuenzae were common in elderly and pediatric patients. Clinical rational use of antimicrobial drugs should be based on the popular features of this region.