356例儿童与老年患者呼吸道感染流感嗜血杆菌耐药性对比研究

Comparative study on drug resistance of Haemophilus influenzae in 356 cases of children and elderly patients with respiratory tract infection

目的:了解儿童及老年患者呼吸道流感嗜血杆菌(Hi)感染现状及耐药性差异,为Hi感染的预防、诊断、治疗提供帮助。方法:对2011-06-2013-06门诊及住院呼吸道感染儿童及老年患者的呼吸道标本进行细菌培养、菌种鉴定、β-内酰胺酶检测、药敏试验,并对结果进行统计分析。结果:儿童患者Hi的分离率约9.6%,产酶率30.2%;老年患者Hi的的分离率约4.1%,产酶率18.5%。氨苄西林、左氧氟沙星、环丙沙星、氯霉素、复方磺胺甲噁唑的耐药率二者之间差异有统计学意义,对其他抗生素则差异无统计学意义。结论:Hi在儿童和老年呼吸道感染中占重要地位,儿童的感染率而及产酶率远高于老年患者,对氨苄西林的耐药儿童高于老年患者,左氧氟沙星、环丙沙星、氯霉素、复方磺胺甲噁唑的耐药老年患者高于儿童,应根据药敏结果,合理选用抗生素。

Objective：To explore the infection status and differences in drug resistance of Haemophilus influenzae of children and elderly patients with respiratory tract infection in our hospital, providing help for prevention, diagnosis and treatment of Hi. influenzae infection. Method：We underwent the bacterial cultures, strain identifications, β-lactamas enzyme detections and drug sensitivity tests on the children and elderly patients＇ respiratory specimens with respiratory tract infection in the outpatients and inpatients of our hospital from Jun, 2011 to Jun 2013. And the results were statistically analyzed. Result： The Hi isolation rate and enzyme producing rate of children patients were about 9.6% and 30.2%, and those of elderly patients were about 4.1% and 18.50%. There were significant differences in the resistant rates to ampicillin, levofloxacin, ciprofloxacin, chloramphenicol and sulfamethoxazole, while no significant differences to other antibiotics. Conclusion： Hi plays an important role in children and elderly＇s respiratory tract infection. The infection rate and enzyme producing rate of children might be much higher than those of the elderly. And the resistance rate to ampicillin of children might be higher than that of the elderly, while the resistance rate to evofloxaein, ciprofloxaein, ehloramphenicol and sulfamethoxazole of the elderly might be higher than those of children. So we should select appropriate antibiotics according to the results of drug sensitivity.