儿童呼吸道感染流感嗜血菌的耐药性变迁

Change of drug resistance of Haemophilus influenzae isolated from children with respiratory tract infections

目的了解儿童呼吸道感染流感嗜血菌(HIN)的耐药性变迁,为合理使用抗菌药物提供依据。方法对2008年1月-2012年4月呼吸道感染及健康儿童咽拭子标本中分离的261株HIN,采用K-B法测定其对12种抗菌药物的敏感性,并用cefinase纸片检测菌株的β-内酰胺酶的产酶率,采用SAS 9.2进行统计分析。结果 2008-2012年共送检717份标本,检出261株HIN,分离率为36.40%;3年呼吸道感染儿童HIN分离率呈下降趋势;健康儿童HIN携带率呈上升趋势;儿童呼吸道感染HIN对亚胺培南、头孢克洛100.00%敏感,健康儿童携带的HIN对亚胺培南、头孢唑林、头孢克洛、环丙沙星、氯霉素等多种抗菌药物敏感,敏感率均为100.00%。结论儿童HIN的分离率较高,对氨苄西林耐药率呈上升趋势,治疗HIN感染应根据药敏试验结果合理选用抗菌药物,无法获得药敏结果可首选亚胺培南、头孢克洛进行治疗。

OBJECTIVE To understand the change of drug resistance of the Haemophilus inf luenzae strains isola‐ted from the children with respiratory tract infections so as to provide guidance for reasonable use of antibiotics . METHODS From Jan 2008 to Apr 2012 ,totally 261 strains of H .influenzae were isolated from the throat swab specimens obtained from the children with respiratory tract infections and healthy children ,then the drug suscepti‐bility to 12 antibiotics was determined by using K‐B method ,the positive rate of production of β‐lactamases was detected with the use of cefinase disk , and the statistical analysis was performed with the use of SAS 9 .2 . RESULTS Totally 717 specimens were submitted from 2008 to 2012 ,and 261 strains of H .influenzae were isola‐ted,withtheisolationrateof36.40% .Theisolationrateofthe H.influenzaeisolatedfromthechildrenwithre‐spiratory tract infections showed a downward trend during the three years ;the carrying rate of H .inf luenzae showedanupwardtrendinthehealthychildren.Thedrugsusceptibilityratesofthe H.influenzaecausingrespir‐atory tract infections in the children to imipenem and cefaclor were 100 .00% ;the drug susceptibility rates of the H .in f luenz ae strains isolated from the healthy children to imipenem ,cefazolin ,cefaclor ,ciprofloxacin ,and chlor‐amphenicol were 100 .00% .CONCLUSION The isolation rate of the H .inf luenzae strains is high in the children , and the drug resistance rate to ampicillin shows an upward trend .It is necessary for the treatment of the H .inf lu‐enz ae infection to reasonably use antibiotics based on the results of the drug susceptibility testing ;imipenem and cefaclor are preferred in case the results of the drug susceptibility testing are not available .