2015—2017年同济医院分离常见苛养菌耐药性分析

Analysis of Antibiotics Resistance of Common Fastidious Microorganism Isolated from Tongji Hospital During 2015-2017

目的 了解常见苛养菌流感嗜血杆菌、肺炎链球菌和卡他莫拉菌对常用抗菌药物的耐药性,为临床经验治疗提供参考依据.方法 回顾性分析华中科技大学同济医学院附属同济医院2015—2017年临床分离的流感嗜血杆菌、肺炎链球菌和卡他莫拉菌的分布,药敏试验结果分析采用世界卫生组织数据分析软件(WHONET)5.6版,耐药率的比较采用SPSS 11.0版统计软件进行分析.结果 该院2015—2017年分离的流感嗜血杆菌、肺炎链球菌和卡他莫拉菌来自呼吸道标本的比例分别为99.0%,84.1%和99.0%.成人组和儿童组分离的流感嗜血杆菌 β-内酰胺酶检出率分别为35.2%和47.5%.成人组和儿童组分离株对头孢噻肟、环丙沙星、左氧氟沙星和氯霉素的敏感率均>90%,儿童组分离株对氨苄西林、氨苄西林/舒巴坦、头孢呋辛和复方磺胺甲唑耐药率显著高于成人组(P<0.01).成人组和儿童组分离的肺炎链球菌对左氧氟沙星、莫西沙星和万古霉素的敏感率均>99.0%,对红霉素和克林霉素耐药率均>85.0%.成人组和儿童组分离的卡他莫拉菌对阿莫西林/克拉维酸和复方磺胺甲唑的敏感率均>95.0%,儿童组分离株对阿奇霉素和红霉素的非敏感率显著高于成人组(P<0.01).结论 该院分离的常见苛养菌主要来自于呼吸道标本,且儿童组分离株对常用抗菌药物的耐药率高于成人组,应引起重视.

Objective To investigate the antibiotic resistance profile of Haemophilus influenzae,Streptococcus pneumoniae,and Moraxella catarrhalis and to provide reference for clinicians ’ experience treatment. Methods Distribution and antibiotics sensitivity results of Haemophilus influenzae,Streptococcus pneumoniae and Moraxella catarrhalis were retrospectively analyzed in Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology during 2015-2017.Analysis of antibiotics sensitivity and comparison of antibiotics resistance rates were performed with WHONET 5.6 and SPSS11.0,respectively. Results The proportions of Haemophilus influenzae,Streptococcus pneumoniae and Moraxella catarrhalis strains in samples collected from respiratory tract specimens were 99.0%,84.1% and 99.0% in that hospital during 2015 ~ 2017,respectively.The detection rates of beta lactamases of Haemophilus influenzae in adult and children groups were 35. 2% and47.5%,respectively.The sensitivity rates of Haemophilus influenzae to cefotaxime,ciprofloxacin,levofloxacin and chloramphenicol were all above 90%. The resistant rates to ampicillin,ampicillin/sulbactam,cefuroxime and trimethoprim/sulfamethoxazole in children group were significantly higher than that in adult group( P<0.01).The susceptibility rates of Streptococcus pneumoniae to levofloxacin,moxifloxacin and vancomycin were all above 99.0%.The resistant rates to erythromycin and clindamycin were above85.0%.The sensitive rates of Moraxella catarrhalis to amoxicillin clavulanic acid and trimethoprim/sulfamethoxazole were above95.0%.The non-sensitive rates to azithromycin and erythromycin in children group were significantly higher than that in adult group( P<0.01). Conclusion The common fastidious microorganisms in that hospital were mainly from the respiratory tract specimens.In addition,the resistance rates to common antibiotics in children group were higher than that in adult group and attention should be paid to it.