509株流感嗜血杆菌的临床分布特征及耐药分析

Clinical Distribution Characteristics and Antibiotic Resistance Analysis of 509 Strains of Haemophilus influenzae

目的:探讨保山地区流感嗜血杆菌的临床分布特征和耐药情况,指导临床合理用药。方法:收集2018年至2022年保山市人民医院分离获得的509株非重复流感嗜血杆菌,使用微生物质谱快速鉴定系统进行菌种鉴定,使用嗜血杆菌药敏试剂盒进行药敏试验,应用SPSS 26.0和Whonet 5.6软件进行数据分析。结果:分离获得的509株流感嗜血杆菌主要分布在痰液、鼻咽分泌物和肺泡灌洗液等呼吸道标本,0~12岁儿童和60岁以上老年人是主要感染群体,未发现对哌拉西林/他唑巴坦、美罗培南、亚胺培南和左氧氟沙星耐药的菌株,对头孢曲松、头孢他啶、头孢吡肟、氨曲南和环丙沙星的耐药率较低,对氨苄西林、头孢呋辛和复方磺胺甲噁唑的耐药率较高。比较β-内酰胺酶阴性菌和β-内酰胺酶阳性菌可知,二者对除头孢曲松和环丙沙星外的所有受试药物的耐药率差异均有统计学意义(P<0.05)。60岁以上老年人与0~12岁儿童对除环丙沙星外的所有受试药物的耐药率差异均有统计学意义(P<0.05)。结论:流感嗜血杆菌的临床分布和耐药性差异较大,需根据患者具体情况制定个体化用药方案。

Objective:To investigate the clinical distribution characteristics and antibiotic resistance of Haemophilus influenzae in Baoshan,in order to guide rational clinical drug use.Methods:A total of 509 non-duplicate strains of Haemophilus influenzae were collected from Baoshan People's Hospital between 2018 and 2022.Species identification was performed using a microbial mass spectrometry rapid identification system,and drug susceptible test was conducted using Haemophilus influenzae drug susceptibility testing kits.Data were analyzed using SPSS 26.0 and Whonet 5.6 software.Results:The 509 strains of Haemophilus influenzae were primarily isolated from respiratory specimens such as sputum,nasopharyngeal secretions,and bronchoalveolar lavage fluid.The main infected populations were children aged 0-12 years and elderly individuals over 60 years of age.No strains were found to be resistant to piperacillin/tazobactam,meropenem,imipenem,or levofloxacin.Low resistance rates were observed for ceftriaxone,ceftazidime,cefepime,aztreonam,and ciprofloxacin.However,high resistance rates were found for ampicillin,cefuroxime,and compound sulfamethoxazole.A comparison betweenβ-lactamase-negative andβ-lactamase-positive strains showed significant differences in resistance rates to all tested antibiotics except ceftriaxone and ciprofloxacin(P<0.05).Similarly,significant differences in resistance rates were observed between elderly individuals over 60 years and children aged 0-12 years for all tested antibiotics except ciprofloxacin(P<0.05).Conclusion:The clinical distribution and antibiotic resistance of Haemophilus influenzae vary significantly.Individualized treatment regimens should be developed based on the specific conditions of the patients.