呼吸道及非呼吸道流感嗜血杆菌感染特征及耐药性分析

Infectious features and antibiotic resistance of Haemophilus influenzae from respiratory tract and non-respiratory tract

目的分析该院呼吸道和非呼吸道流感嗜血杆菌的感染特征及耐药情况,为临床合理用药提供依据。方法对2016-2019年该院呼吸道和非呼吸道标本检出的流感嗜血杆菌进行分析,采用Kirby-Bauer法检测抗菌药物的敏感性,采用头孢硝噻吩纸片法检测β-内酰胺酶的活性。结果共检出流感嗜血杆菌284株,包括呼吸道来源270株(95.07%)和非呼吸道来源14株(4.93%)。婴幼儿(0~3岁)对流感嗜血杆菌的易感性明显高于其他年龄段人群(P<0.05),老年人(>59岁)较青少年(>14~18岁)和成年人(>18~59岁)易感(P<0.05)。流感嗜血杆菌感染呈春、冬季高发性,其感染高峰在2-5月。270株呼吸道来源的流感嗜血杆菌包括β-内酰胺酶阳性且对氨苄西林耐药147株(54.44%)、β-内酰胺酶阴性且对氨苄西林耐药34株(12.60%)和β-内酰胺酶阴性且对氨苄西林敏感89株(32.96%)。14株非呼吸道来源流感嗜血杆菌包括β-内酰胺酶阳性且对氨苄西林耐药2株,β-内酰胺酶阴性且对氨苄西林耐药2株,β-内酰胺酶阴性且对氨苄西林敏感10株。呼吸道来源的流感嗜血杆菌对氨苄西林、氨苄西林/舒巴坦和头孢呋辛钠的耐药率明显高于非呼吸道菌株(P<0.05)。结论该院呼吸道来源的流感嗜血杆菌耐药率高于非呼吸道菌株,临床医师应根据病原菌分布及耐药特征选用抗菌药物,确保合理用药。

Objective To analyze the infectious characteristics and drug resistance of Haemophilus influenzae from respiratory tract and non-respiratory tract in this hospital to provide a basis for clinical rational medication.Methods Haemophilus influenzae detected from the respiratory tract and non-respiratory tract samples in this hospital during 2016-2019 was analyzed.The sensitivity of antibacterial drugs was detected by the Kirby-Bauer method and theβ-lactamase activity was detected by the cephanosporin paper method.Results A total of 284 strains of Haemophilus influenzae were detected,including 270(95.07%)strains of respiratory tract source and 14(4.93%)strains of non-respiratory tract source.The susceptibility to Haemophilus influenzae of the infants(aged 0-3 years old)was significantly higher than that of other age groups,the elderly people(aged>59 years old)were more susceptible than the adolescents(>14-18 years old)and adults(>18-59)(P<0.05).Haemophilus influenzae infection showed high onset in winter and spring,its infection peak was in February to May.Among 270 strains of Haemophilus influenzae from respiratory tract,there were 147 strains(54.44%)ofβ-lactamase-positive and resistant to ampicillin,34 strains(12.60%)ofβ-lactamase-negative and resistant to ampicillin and 89 strains(32.96%)ofβ-lactamase-negative and sensitive to ampicillin.Fourteen strains of Haemophilus influenzae from non-respiratory tract source included 2 strains ofβ-lactamase-positive and resistant to ampicillin and 2 strains ofβ-lactamase-negative and resistant to ampicillin and 10 strains ofβ-lactamase-negative and sensitive to ampicillin.The resistance rates of Haemophilus influenzae from respiratory tract to ampicillin,ampicillin/sulbactam and cotrimoxazole were significantly higher than those from non-respiratory tract.Conclusion The drug resistance rate of Haemophilus influenzae from respiratory tract source is higher than that from non-respiratory tract.Clinical doctors should choose antibacterial drugs according to the infection distribution and drug resistance characteristics of pathogenic bacteria for ensuring the rational medication.