住院精神病患者感染流感嗜血杆菌耐药基因检测及耐药性分析

Detection and analysis of drug resistance gene of Haemophilus influenzae in inpatients with mental illness

目的 分析住院精神病患者呼吸道感染所分离的97株流感嗜血杆菌的耐药基因及耐药特征,为控制流感嗜血杆菌感染及临床合理应用抗菌药物提供参考。方法 病原菌鉴定采用法国梅里埃VITEK 2 Compact全自动微生物分析仪鉴定;采用头孢硝噻酚试验检测β-内酰胺酶;PCR法检测TEM和ROB耐药基因;药敏试验采用K-B纸片扩散法。结果 97株流感嗜血杆菌检出产β-内酰胺酶阳性菌株36株,阳性率为37. 11%;检出TEM耐药基因39株,占40. 21%,其中7株为β-内酰胺酶检测阴性菌株;ROB耐药基因检出4株,占4. 12%。药敏试验显示,β-内酰胺酶阳性菌株对氨苄西林、阿莫西林耐药率分别为75. 00%和72. 22%,显著高于β-内酰胺酶阴性菌株(P<0.05)。结论 本院住院精神病患者呼吸道感染其呼吸道分泌物标本分离的流感嗜血杆菌耐药基因型主要为TEM耐药基因型,对β-内酰胺类药物具有较强耐药性,对阿奇霉素、头孢菌素、喹诺酮类有较高敏感性。

Objective To analyze the resistance genes and drug resistance characteristics of 97 strains of Haemophilus influenzae isolated from inpatients with respiratory tract infection,so as to provide reference for controlling Haemophilus influenzae infection and rational clinical application of antimicrobial agents.Methods The pathogenic bacteria were identified by the French Merier VITEK 2 Compact automatic microbial analyzer;β-lactamase was detected by cefnitrothiol assay.TEM and ROB drug resistance genes were detected by PCR.K-B disk diffusion method was used for drug sensitivity test.Results The positive rate of β-lactamase was 37.11% in 36 strains of 97 strains of Haemophilus influenzae.39 strains(40.21%)were found to be resistant to TEM,among which 7 strains were negative for β-lactamase detection.ROB resistance gene was detected in 4 strains,accounting for 4.12%.Drug sensitivity test showed that the drug resistance rates of β-lactamase positive strain to ampicillin and amoxicillin were 75.00% and 72.22%,respectively,significantly higher than that of β-lactamase negative strain(P<0.05).Conclusion The drug-resistance genotype of Haemophilus influenzae was mainly tem-resistant genotype of respiratory tract samples isolated from patients with respiratory tract infection in our hospital,which was highly resistant to beta-lactams and highly sensitive to azithromycin,cephalosporins and quinolones.