儿童呼吸道感染肺炎链球菌、流感嗜血杆菌检出情况及耐药性变迁

Detection and Antimicrobial Resistance of Streptococcus Pneumoniae and Haemophilus Influenzae in Children's Respiratory Tract Infection

目的:探讨我院2010年1月至2015年6月儿童呼吸道感染肺炎链球菌、流感嗜血杆菌的分布及耐药性变迁。方法:对2010年1月至2015年6月武汉大学人民医院儿科住院患儿痰标本中分离的肺炎链球菌和流感嗜血杆菌的分布和药敏试验结果进行回顾性分析。结果:肺炎链球菌的总检出率为7.2%,对复方磺胺甲唑的耐药率>50.0%,对红霉素和克林霉素的耐药率>97.0%,且有逐年升高趋势;对青霉素的耐药率从7.7%上升到93.7%,对头孢噻肟、头孢吡肟、亚胺培南的耐药率基本保持在40.0%左右;未发现对万古霉素和利奈唑胺耐药的肺炎链球菌。流感嗜血杆菌的总检出率为3.9%,对复方磺胺甲唑的耐药率均>60.0%,对氨苄西林的耐药率从33.3%上升到48.9%,对头孢呋辛的耐药率从6.7%上升到17.2%;未发现对头孢噻肟、亚胺培南、阿奇霉素、环丙沙星耐药的流感嗜血杆菌;β-内酰胺酶阳性率为37.8%,β-内酰胺酶阴性菌株的检出率为6.5%。结论:儿童呼吸道感染肺炎链球菌、流感嗜血杆菌的耐药现象普遍,临床应根据药敏试验结果合理使用抗菌药物。

Objective： To investage the distribution and transition of antimicrobial resistance of Streptococcus pneumoniae and Haemophilus influenzae in children with respiratory tract infection.Methods： A retrospective analysis of the distribution and antimicrobial resistance for Streptococcus pneumoniae and Haemophilus influenzae which were isolated from pediatric inpatients＇ sputum specimens were performed from January 2010 to June 2015 in Renmin Hospital of Wuhan University.Results： The total detection rate of Streptococcus pneumoniae was 7.2%,the resistance rate to compound sulfamethoxazole was more than 50.0%,the resistance rate to erythromycin and clindamycin were more than 97.0% and rising year by year,the resistance rate to penicillin was increased from 7.7%to 93.7% and the resistance rate to cefotaxime,cefepime,imipenem were remain nearly 40.0%.And we hadn ＇t discovered the bacterial strains which were resistance to vancomycin and linezolid.The total detection rate of Haemophilus influenzae was 3.9%,the resistance rate to compound sulfamethoxazole was more than 60.0%,the resistant rate to ampicillin had rose from 33.3% to 48.9%,and the resistant rate to cefuroxime had rose from 6.7% to 17.2%.And we hadn＇t discovered the bacterial strains which were resistance to cefotaxime,imipenem,azithromycin,and ciprofloxacin.A total positive rate of β-lactamase was 37.8%.The total detection rate of BLNAR strains was 6.5%.Conclusion： The resistance phenomenon of Streptococcus pneumoniae and Haemophilus influenza in children were common.Children with respiratary tract infection should use antibiotic drugs properly based on drug sensitivity results.