柳州地区儿童感染流感嗜血杆菌及肺炎链球菌的情况分析

Analysis on Haemophilus influenzae and Streptococcus pneumoniae infections in children in Liuzhou region

目的了解柳州地区儿童呼吸道感染的流感嗜血杆菌、肺炎链球菌菌株及耐药性。方法对2014年12月-2015年11月柳州市妇幼保健院收治的肺炎、急性上呼吸道感染儿童的痰、肺泡灌洗液样本进行培养、鉴定,对阳性菌株的抗生素耐药情况进行分析。结果流感嗜血杆菌分离率为9.8%,<2岁婴幼儿比2~5岁儿童更易受流感嗜血杆菌感染,经比较差异有统计学意义(χ~2=41.03,P<0.05);2~5岁儿童分离的流感嗜血杆菌对头孢呋辛及头孢噻肟的耐药性高于<2岁婴幼儿,经比较差异均有统计学意义(χ~2=5.73、7.99,均P<0.05)。2~5岁儿童组分离的肺炎链球菌对青霉素、阿莫西林、头孢噻肟的耐药性均高于<2岁婴幼儿(均P<0.05)。结论柳州地区儿童流行的流感嗜血杆菌及肺炎链球菌对复方新诺明的耐药率较高,仍需继续对儿童群体流行的菌株进行耐药性监测,以便于临床选择治疗儿童急性呼吸道感染的药物。

Objective To investigate the drug resistance of Haemophilus influenzae and Streptococcus pneumoniae strains isolated from children with respiratory tract infection in Liuzhou region. Methods Culture and identification of Haemophilus influenzae and Streptococcus pneumoniae in phlegm and bronchoalveolar lavage fluid of children with pneumonia and acute upper respiratory infection in the hospital from December 2014 to November 2015 were conducted. Drug resistance of positive strains was analyzed. Results The isolation rate of Haemophilus influenzae was 9. 8%,compared with children aged 2-5 years old,the children under 2 years old were more susceptible to Haemophilus influenzae infection,there was statistically significant difference（ χ^2= 41. 03,P〈0. 05）. The drug resistance rates of Haemophilus influenzae to cefuroxime and cefotaxime in children aged 2-5 years old were statistically significantly higher than those in children under 2 years old（ χ^2= 5. 73,7. 99,all P〈0. 017）. The drug resistance rates of Streptococcus pneumoniae to penicillin,amoxicillin,and cefotaxime in children aged 2-5 years old were statistically significantly higher than those in children under 2 years old（ all P〈0. 05）.Conclusion The drug resistance rates of Haemophilus influenzae and Streptococcus pneumoniae to trimethoprim-sulfamethoxazole among children in Liuzhou region are relatively high,monitoring of drug resistance of strains among children is still needed to help clinical choice of antibacterial drugs of pediatric acute respiratory tract infection.