成都地区儿童下呼吸道感染卡他莫拉菌的特点及耐药性分析

Study on the Infection Characteristics and Antibiotic Resistance Profile of Moraxella Catarrhalis in Children with Lower Respiratory Tract Infection in Chengdu

目的:研究成都地区儿童下呼吸道感染中卡他莫拉菌的感染情况,为临床诊断和合理使用抗生素提供参考。方法:收集2018年2月至2020年1月四川省骨科医院和成都市妇女儿童中心医院儿科送检的15891例0~14岁下呼吸道感染患儿的痰液标本,进行卡他莫拉菌的鉴定和药敏试验并进行统计分析。结果:15891例痰标本中共检出卡他莫拉菌3333株,总检出率为20.97%;感染卡他莫拉菌的患儿无性别差异(P>0.05);卡他莫拉菌在>1~3岁年龄组中检出率最高,≤28 d年龄组检出率最低;不同季节卡他莫拉菌的检出率结果比较差异有统计学意义(P<0.05),其中冬季检出率最高,夏季检出率最低;卡他莫拉菌的β-内酰胺酶阳性率为98.47%,对阿莫西林/克拉维酸、头孢噻肟、氧氟沙星、四环素、氯霉素和利福平的敏感率均>90%。结论:1~6岁儿童在冬季容易感染卡他莫拉菌,且在轻痉肺炎中检出率最高,β-内酰胺酶阳性率达98.47%,阿莫西林/克拉维酸、头孢噻肟可以作为治疗的首选药,临床医师可以参考卡他莫拉菌的感染特点和耐药情况进行诊疗和临床用药。

Objective:To explore the infection characteristics and antibiotic resistance of Moraxella catarrhalis in lower respiratory tract infection specimens from children in Chengdu,and to provide a reference for clinical diagnosis and rational use of antibiotics.Methods:The sputum samples of 15,891 children aged 0-14 with lower respiratory tract infection admitted to the Department of Pediatrics of Sichuan Provincical Orthopedic Hospital and Chengdu Women’s and Children’s Central Hospital of Sichuan Province from February 2018 and January 2020 were collected,and the identification of Moraxella catarrhalis and their drug susceptibility were determined.Results:A total of 3,333 strains of Moraxella catarrhalis were detected in 15,891 children’s sputum samples,and the isolating rate was 20.97%.The gender of children infected with Moraxella catarrhalis was not statistically significant(P>0.05);the isolating rate was the highest in children aged>1 to 3,and the lowest was in the age group≤28 d.The isolating rate of Moraxella catarrhalis in different seasons had statistically significant differences(P<0.05),with the highest isolating rate in winter and the lowest in summer.The beta-lactamase positive rate of Moraxella catarrhalis was 98.47%,and the susceptibility to amoxicillin/clavulanic acid,cefotaxime,ofloxacin,tetracycline,chloramphenicol,and rifampicin were all more than 90%.Conclusion:Children aged 1 to 6 are susceptible to Moraxella catarrhalis in winter,and the detection rate of pneumonia is usually highest,and the beta-lactamase positive rate of Moraxella catarrhalis reaches 98.47%.Amoxicillin/clavulanic acid and cefotaxime can be used as the first choice for treatment.In order to control the infection better,clinicians can refer to the characteristics and antibiotic resistance when taking the diagnosis and treatment for patients.