儿童卡他莫拉菌呼吸道感染的耐药性研究

Drug resistance of Moraxella catarrhalis causing respiratory tract infections in children

目的探讨儿童呼吸道卡他莫拉菌的感染率与耐药性,为指导临床合理用药提供参考依据。方法选取2012年1月-2015年1月医院收治的1 240例呼吸道感染患儿,对其送检标本进行病原菌培养和药敏试验,采用K-B纸片法进行药敏试验,药敏结果按照美国临床实验室标准化研究所(CLSI)标准进行判定,采用SPSS20.0软件对数据进行统计分析。结果 1 240份标本共分离出138株卡他莫拉菌,检出率为11.13%,其中肺炎、哮喘并发感染、毛细支气管炎、支气管炎分别占66.67%、15.22%、10.14%和7.97%;卡他莫拉菌感染患儿性别比较差异无统计学意义,年龄分布和感染季节分布比较,差异有统计学意义(P<0.05);卡他莫拉菌对阿莫西林/克拉维酸、环丙沙星、左氧氟沙星、克拉霉素、头孢哌酮/舒巴坦和亚胺培南敏感率均>90.00%。结论儿童作为卡他莫拉菌感染的高危人群,尤其对于3岁以下和冬季患病儿童,应及时行药敏试验,合理选择抗菌药物治疗。

OBJECTIVE To explore the incidence of Moraxella catarrhalis respiratory tract infections in children and analyze the drug resistance so as to provide guidance for reasonable clinical use of antibiotics.METHODS A total of 1 240 children with respiratory tract infections who were treated in the hospitals from Jan 2012 to Jan 2015 were enrolled in the study,then the submitted specimens were cultured for pathogens,the drug susceptibility testing was carried out by using K-B disk method,the results of the drug susceptibility testing were interpreted according to the standards of Clinical Laboratory Standard Institute（CLSI）,and the statistical analysis of data was performed with the use of SPSS20.0software.RESULTS Totally 138 strains of M.catarrhalis were isolated from1 240 specimens,with the isolation rate of 11.13%.Of the isolated M.catarrhalis strains,66.67% were isolated from the children with pneumonia,15.22% were isolated from the children with asthma complicated with infections,10.14% were isolated from the children with capillary bronchitis,and 7.97% were isolated from the children with bronchitis.There was no significant difference in the incidence of M.catarrhalis infections between the genders of the children,however,there was significant difference in the distribution of age or seasons of infections（P〈0.05）.The drug susceptibility rates of the M.catarrhalis to amoxicillin-clavulanic acid,ciprofloxacin,levofloxacin,clarithromycin,cefoperazone-sulbactam,and imipenem were more than 90.00%.CONCLUSION The children are at high risk of M.catarrhalisinfections,especially the children aged less than 3years old and the children having diseases in winter.It is necessary to perform the drug susceptibility testing in a timely manner so as to reasonably use antibiotics.