我院嗜血杆菌分离率和耐药性监测

Isolated Rate and Drug-resistance of Haemophilus: A Surveillance Report

目的 调查我院 2 0 0 0～ 2 0 0 1年流感嗜血杆菌和副流感嗜血杆菌的分离率并对其耐药进行分析。方法 标本接种于嗜血杆菌巧克力平板 ,对分离到的流感嗜血杆菌和副流感嗜血杆菌进行鉴定、β 内酰胺酶试验和药敏试验。结果 2 0 0 0年 974份呼吸道标本检出流感嗜血杆菌 8株 ,产 β 内酰胺酶株 0 % ,副流感嗜血杆菌 13株 ,产 β 内酰胺酶株 7.6 9% ;2 0 0 1年 84 5份呼吸道标本检出流感嗜血杆菌 2 5株 ,产 β 内酰胺酶 2 4 % ,副流感嗜血杆菌12 0株 ,产 β 内酰胺酶 17.5 % ;检出 1株 β 内酰胺酶阴性氨苄西林耐药株。 结论 嗜血杆菌是呼吸道感染的主要致病菌 ,培养基质量是提高嗜血杆菌分离率的一个重要条件 ,流感嗜血杆菌产 β 内酰胺酶 2 0 0 1年达 2 4 % ,但多重耐药的嗜血杆菌并不常见 ,加酶抑制剂的 β 内酰胺类抗生素仍然是目前治疗嗜血杆菌感染有效抗生素 ,但副流感嗜血杆菌耐药比流感嗜血杆菌复杂 ,且存在有β 内酰胺酶以外的耐药机制 ,给临床治疗带来困难 ,加强嗜血杆菌耐药谱监测 ,合理谨慎使用抗生素是延缓耐药菌株快速上升的最好办法。

OBJECTIVE To investigate isolated rate and drug resistance of Haemophilus influenzae and H. parainfluenzae during 2000-2001 in our hospital, and to provide a resistance analysis. METHODS Samples were in chocolate Haemophilus agar and their strains were isolated and identified. Their β lactamase producing capability and drug resistane were tested. RESULTS In 2000 among 974 samples from the respiratory tract were fond 8 strains of H.influenzae, from which none(0%) was β lactamase producing and 13 strains of H.parainfluenzae, from which 7.69% were β lactamase producing. In 2001 among 845 samples both indexes were 25 strains, 24% and 120 strains, 17.5%, respectively, but was fond 1 strain, which was β lactamase negative and ampicillin resistant. CONCLUSIONS Haemophilus is a very important pathogen in the respiratory tract infections, the culture medium quality is a key factor to raise its isolated rate. In 2001 24% strains of H.influenzae were β lactamase producing, which were seldom multi drug resistant. But the resistance of H.parainfluenzae is more complex than the H.influenzae. The other resistance mechanism is occurred yet, which will produce more difficulties in the process of treatment. So the correct use of the antibiotics is the best way to decrease the drug resistance.