宁波市某医院儿童流感嗜血杆菌感染临床特征和耐药性分析

Clinical characteristics and drug resistance of Haemophilus influenzae infection in children in a hospital of Ningbo

目的了解宁波市某医院儿童感染流感嗜血杆菌临床特征和耐药情况,为临床合理使用抗菌药物提供实验室依据和用药指导。方法收集2017年1月—2021年12月宁波市妇女儿童医院儿童患者(≤14岁)分离培养出的90株流感嗜血杆菌临床资料及药敏结果,进行统计学分析。结果该院流感嗜血杆菌感染以3~6岁的学龄前儿童为主(38.89%),春季高发(52.22%),血清学不可分型菌株占94.33%,β-内酰胺酶产酶率87.80%。对氨苄西林、复方新诺明、头孢克洛、头孢呋辛、氨苄西林/舒巴坦和红霉素耐药率分别为82.23%、75.98%、74.99%、61.83%、56.94%和35.74%;未发现对头孢曲松、头孢噻肟、左旋氧氟沙星和阿奇霉素耐药菌株。结论本地区流感嗜血杆菌不可分型占绝对优势,产β-内酰胺酶严重,对氨苄西林和氨苄西林/舒巴坦严重耐药,临床经验用药应选择三代头孢菌素抗菌药物。

Objective To understand the clinical characteristics and drug resistance of Haemophilus influenzae infection in children in a hospital of Ningbo,and to provide laboratory basis and medication guidance for the rational use of antibiotics.Methods The clinical data and drug sensitivity results of 90 strains of Haemophilus influenzae isolated from children(≤14 years old)in the hospital from January 2017 to December 2021 were collected and statistically analyzed.Results Haemophilus influenzae infection in our hospital was mainly in preschool children aged 3 to 6 years old(38.89%),with a high incidence in spring(52.22%).Strains that could not be serotyped accounted for 94.33%,and the production rate ofβ-lactamase was 87.80%.The resistance rates to ampicillin,sulfamethoxazole,cefaclor,cefuroxime,ampicillin/sulbactam and erythromycin were 82.23%,75.98%,74.99%,61.83%,56.94%and 35.74%,respectively;no strains resistant to ceftriaxone,cefotaxime,levofloxacin and azithromycin were found.Conclusion Most of Haemophilus influenzae in this region can not be serotyped,and produceβ-lactamases seriously and are highly resistant to ampicillin and ampicillin/sulbactam.The third-generation cephalosporin antibiotics should be selected for clinical experience.