成人呼吸道嗜血杆菌属分离株生物学分型及药敏测定  

Biotyping and susceptibility testing of Haemophilus strains isolated from respiratory tract of adults

作　　者：杨旭[1] 杨红英[1] 吴昉[1] 胡家鹏[1] 何薇[1] 

机构地区：[1]昆明医学院第二附属医院检验科,650101

出　　处：《中国感染与化疗杂志》2008年第6期452-455,共4页Chinese Journal of Infection and Chemotherapy

摘　　要：目的了解本院临床分离的嗜血杆菌属的季节分布、生物学分型和药敏情况,为临床合理用药及制订预防措施提供依据。方法收集成人呼吸道感染患者的痰和咽拭子4719份(2006—2007年),细菌的鉴定用VITEK-32鉴定到型,用K-B法测定对13种抗菌药物的药敏,用VITEK-32进行β内酰胺酶检测,数据统计采用WHONET5.1软件。结果分离到228株嗜血杆菌属,分离率4.8%,其中流感嗜血杆菌118株(2.5%),生物Ⅲ型31株(26.3%)、生物Ⅳ型82株(69.5%),其他生物型5株(4.2%)。副流感嗜血杆菌110株(2.3%),生物Ⅲ型38株(34.5%)、生物Ⅳ型68株(61.8%)、其他生物型4株(3.6%)。冬季与春、夏、秋3个季节嗜血杆菌的阳性率比较差异有统计学意义。流感嗜血杆菌对氨苄西林、复方磺胺甲口恶唑和氯霉素的耐药率分别为33.9%、57.6%和59.4%;副流感嗜血杆菌对氨苄西林、复方磺胺甲口恶唑和氯霉素的耐药率分别为40.0%、89.1%和36.4%;对氨苄西林耐药的菌株β内酰胺酶都为阳性,未发现β内酰胺酶阳性阿莫西林-克拉维酸耐药的菌株;所有菌株对阿莫西林-克拉维酸、氨曲南、环丙沙星、左氧氟沙星、亚胺培南、头孢他啶、头孢噻肟、头孢呋辛和头孢吡肟均为100%敏感。结论研究结果表明流感嗜血杆菌和副流感嗜血杆引起的成人呼吸道感染好发于冬季,2种细菌的感染率相近。都是以生物Ⅲ、Ⅳ型为主;对氨苄西林和氯霉素产生较高的耐药性,对复方磺胺甲口恶唑耐药性最高。在本地区不产β内酰胺酶菌株所致呼吸道感染仍可选用氨苄西林治疗,阿莫西林-克拉维酸可作为产酶菌株的指导性用药。Objective To characterize the season distribution, biotypes and antibiotic susceptibility of Haernophilus influenzae and Haemophilus parainfluenzae strains isolated from adults in our hospital in order to guide empirical prescribing and prevent infections. Methods A total of 4 719 samples of sputum or throat swab were collected from adult patients during 2006-2007. Biotypes of these strains were identified by VITEK-32 system. β-lactamase production was assessed by VITEK-32. Antibiotic susceptibility testing was based on Kirby-Bauer disc diffusion technique. WHONET 5.1 software was used to analyze the data. Results A total of 228 （4.8%） Haernophilus isolates were identified, including H. influenzae （118, 2.5%） and H. parainfluenzae （110, 2.3%）. Thirty-one （26.3%） strains of H. influenzae were identified as type Ⅲ , 82 （69.5%） as type Ⅳ and 5 （4.2%） as other types. Thirty-eight （34.5%） strains of H. parain fluenzae were identified as type Ⅲ, 68 （61.8%） as type Ⅳ, and 4（3.6%）as the other type. The prevalence of Haernophilus was significantly higher in winter than in spring, summer or autumn. About 33.9%, 57.6% and 59.4% of the H. influenzae isolates were resistant to ampieillin, trimethoprim-sulfa- methoxazole and chloramphenicol respectively. About 40.0%, 89.1 % and 36.4% of the H. parainfluenzae isolates were re sistant to ampicillin, triraethoprim sulfamethoxazole and chloramphenicol respectively. All ampicillin-resistant strains were β- lactamase producers. No β-lactamase positive isolate was found resistant to amoxieillin-clavulanic acid. All isolates were susceptible to amoxicillin-clavulanate, cefotaxime, imipenem, ciprofloxacin, levofloxacin, aztreonam, eeftazidime and cefepime. Conclusions The respiratory tract infections in adults due to H. influenzae or H. parainfluenzae were more frequently found in winter. Type Ⅲ and type Ⅳ were the most prevalent types. These prevalent strains were more resistant to ampicillin and ehloramphenicol, and highly resistant

关 键 词：呼吸道 流感嗜血杆菌 副流感嗜血杆菌 生物分型 药敏 β内酰胺酶 

分 类 号：R446.5[医药卫生—诊断学]