2013-2014年三门县儿童呼吸道流感嗜血杆菌生物分型及耐药性分析

Biological Typing and Drug Resistance of the Haemophilus Influenzae of Children with Respiratory Infections in Sanmen County from 2013 to 2014

目的:探讨浙江省三门县儿童呼吸道流感嗜血杆菌(Hi)的生物分型及耐药性。方法:回顾性分析2013年1月至2014年12月在浙江省三门县人民医院儿科门诊与住院部治疗的呼吸道感染患儿7 140例,采用无菌负压吸引法采集新鲜痰液,进行流感嗜血杆菌培养、分离,进行生物分型,使用生物鉴定仪、鉴定卡、药敏试剂盒进行药敏试验并对其β-内酰胺酶进行检测。结果:7 140例儿童呼吸道感染患儿分离出337株Hi;生物学分型以Ⅱ型和Ⅲ型所占比例最大,二者占全部Hi菌株的91.4%;337株Hiβ-内酰胺酶阳性率为32.64%(110/337);Hi的各类抗菌药物耐药性检测中氨苄西林的耐药率最高;Hi对阿莫西林/克拉维酸、四环素、头孢噻肟、利福平、氯霉素等的敏感率均大于90%,对氧氟沙星、头孢呋辛、头孢克洛等敏感率均大于80%。结论:2013年—014年三门县儿童呼吸道Hi生物学分型以Ⅱ型、Ⅲ型为主,且Ⅱ型产β-内酰胺酶的几率最高,Hi对氨苄西林的耐药率最高,对阿莫西林/克拉维酸、四环素、头孢噻肟、利福平、氯霉素等的敏感率均大于90%,阿莫西林/克拉维酸是治疗Hi感染的首选药物。

Objective： To analyze the biological typing and drug resistance of Haemophilus influenzae（ Hi） in children with respiratory infections in Sanmen area. Methods： Analyzed the clinical data of 7,140 cases of children with respiratory tract infection from January2013 to December 2014 in pediatric outpatient and the inpatient of Sanmen Ppeople＇s Hospital of Zhejiang Province retrospectively,aseptic pressure suction method was adopted to collect fresh sputum,Hi was cultured,separated,biological classified,used the biological identification,identification card,susceptibility kits for drug sensitive test and the β-lactamase was tested. Results： A total of337 strains of Hi were isolated in 7,140 cases of children with respiratory tract infection. Biological type Ⅱ and type Ⅲ accounted for the largest proportion,91.4% of all Hi. β-actamase positive rate was 32.64%（ 110 / 337）. Resistance rate to benzyl chloride methicillin was the highest in all kinds of antibacterial drug resistance to Hi, the sensitivity rate to amoxicillin / clavulanate acid, tetracycline,cefotaxime,rifampicin,chloramphenicol of Hi were greater than 90%,the sensitivity rate to ofloxacin,cefuroxime,cefaclor of Hi were greater than 80%. Conclusion： Biological type Ⅱ and type Ⅲ of Hi accounted for the largest proportion in children with respiratory infections from 2013 to 2014 in Sanmen county children,and type Ⅱ produced β-lactamase,the resistance rate to benzyl chloride methicillin was the highest, the sensitivity rate to amoxicillin / clavulanic acid, tetracycline, cefotaxime cefotaxime, rifampicin,chloramphenicol were greater than 90%. So amoxicillin / clavulanic acid is the choice for treatment of Hi infection.