146株流感嗜血杆菌的生物学分型及耐药性分析  

Analysis of 146 Strains of Haemophilus Influenzae Biotypes and Antibiotic Resistance

作　　者：陈碧英[1] 马晨芸[1] 陈佩宏[1] 段爱华[1] 

机构地区：[1]上海市第七人民医院检验科,上海200137

出　　处：《现代检验医学杂志》2010年第2期92-94,共3页Journal of Modern Laboratory Medicine

摘　　要：目的了解引起呼吸道感染的流感嗜血杆菌主要生物型及其对常用抗生素的耐药性。方法收集上海市第七人民医院2005年1月-2009年4月146株流感嗜血杆菌临床分离株，采用APINH细菌鉴定井进行生物学分型，头孢硝噻吩纸片法进行β-内酰胺醇试验，微量稀释法进行药物敏感试验。结果流感嗜血杆菌Ⅱ型分离率最高为39．0％，其次为Ⅱ型29．5％，Ⅰ型27．4％，Ⅳ～Ⅶ型4．1％。产β-内酰胺酶菌株占49．3％，其中Ⅱ型、Ⅲ型产酶率高分别为66．7％和62．8％，Ⅰ型产酶率仅为17．5％，其它生物型中未栓出。流感嗜血杆菌对氨苄西林、复方磺胺耐药率高，分别为46．6％，41．1％，对阿莫西林／克拉雏酸、左氧氟沙星、头孢噻肟耐药率为0。结论呼吸道流感嗜血杆菌感染的主要生物型是Ⅱ型，菌株产β-内酰胺酶严重，舍酶抑制剂抗生素、氟喹诺酮类、三代头孢菌素可作为产酶菌株的首选药物。Objective To investigate the main biotypes and the antibiotic resistance of Haemophilus influenzae strains isolated from respiratory tract infections in Shanghai Seventh People＇s hospital. Methods A total of 146 strains of H. influenzae were collected in Shanghai Seventh People＇s Hospital during January 2005 to April 2009. All of the isolates were identified and blotyped by API NH,β-laetamase production was determined by a nitrocefin disc test ,and antibiotic susceptibility testing was carried out by microdilution method. Results The most prevalent biotypes of H. influenzae were Ⅱ 39. 0%, Ⅲ 29. 5%, Ⅰ 27. 4% ,and the remaining 4.1% were made up of biotypes Ⅳ,Ⅴ,Ⅵ,Ⅶ,β-lactamases were 49.3% of the all isolates,biotype Ⅱ -66.7% ,biotype Ⅲ-62.8% ,while only 17.5% in biotype Ⅰ ,no strains produced β-laetamases in other biotypes. Of the H. influenzae,46.6% were resistant to ampicillin,41.1% to co-trimoxazole,and totally susceptible to amoxicillin-clavulanate,levofloxacin,ceftriaxone. Conclusion This study revealed that biotypes Ⅱ were the predominant biotypes of H. influenzae found in respiratory tract infections in our hospital,and a higher frequency of β-actamase production being reported. Enzyme inhibitors antibiotic, fluoroquinolon and third generation eephalosporins can be indicated for treatment of strains produced β-lactamases.

关 键 词：流感嗜血杆菌 生物型 耐药性 

分 类 号：R378.41[医药卫生—病原生物学] R372[医药卫生—基础医学]