昆明地区儿童下呼吸道感染流感嗜血杆菌分离株的耐药性和血清分型研究  

Study on serotype and drug resistance of haemophilus influenzae isolates from children with respiratory tract infection in Kunming

作　　者：胡莹[1] 夏晓玲[1] 黄海林[2] 单斌[3] 李丰良[4] 黄云昆 刘晓莉[1] 

机构地区：[1]昆明医科大学第二附属医院检验科,云南昆明650101 [2]昆明市儿童医院检验科 [3]昆明医科大学第一附属医院检验科 [4]云南省第一人民医院检验科 [5]昆明市延安医院检验科

出　　处：《实验与检验医学》2013年第2期118-120,共3页Experimental and Laboratory Medicine

摘　　要：目的了解昆明地区急性下呼吸道感染患儿中分离的流感嗜血杆菌体外耐药模式和血清分型情况。方法收集2009年1月1日至2010年1月1日4家三甲医院的儿科和儿童医院急性呼吸道感染患儿鼻咽分泌物或深部吸痰标本分离的流感嗜血杆菌,用头孢硝噻酚法检测β-内酰胺酶,纸片扩散法检测其对抗菌药物的敏感性,并用玻片凝集法对流感嗜血杆菌进行血清分型。结果流感嗜血杆菌对氨苄西林的敏感率为52%,耐药率为42.7%;32株β-内酰胺酶阳性,产酶率为17.6%;菌株对头孢哌酮-舒巴坦、亚胺培南、阿莫西林-克拉维酸、头孢噻肟、头孢曲松和头孢呋辛、阿奇霉素的敏感率为93.4%-100.0%,对复方磺胺磺胺甲噁唑的耐药率最高,达78%;产β-内酰胺酶流感嗜血杆菌多重耐药率达65.6%;血清分型以不定型株为主,Hib仅占1.57%。结论昆明地区急性呼吸道感染儿童流感嗜血杆菌的耐药性和产酶率呈上升趋势,临床应根据药敏结果合理使用抗菌药物。血清分型以不定型株为主,流感嗜血杆菌b分离率不高。Objective To investigate serotype and antibiotics resistance patterns of Haemophilus influenzae （Hi） isolated from children with respiratory tract infection in Kunming. Methods 182 isolates from sputum and throat swabs of children with acute respiratory tract infection were collected. Nitrocefin test was used to detect [3-1actamase. The sensitivities of antibiotics against 182 strains were determined in vitro by Kirby-Bauer diffusion method, and serotypes were measured by Haemophilus Influenzae Antiserum. Results The susceptibility to AMP was 52% while the resistance rate was 42.7%. The prevalence of 13- lactamase was 17.6% in all Hi isolates. The sensitive rates to CFS, IMP, AMC, CXT, and CRO were from 93.4% to 100.0%. The resistance rate of SXT was 78% which was the highest one. Hib accounted only 1.57% among all Hi strains. Conclusions The resistance rate of Hi isolated from children in Kunming is in an upward trend, so antibiotics should be used rationally and be based on the drug sen- sitivity results in clinical therapy. NTHi is the major serotype of Hi in children with acute respiratory tract infection. The preva- lence of Hib is low.

关 键 词：流感嗜血杆菌 耐药性 Β-内酰胺酶 血清型 儿童 

分 类 号：R446.5[医药卫生—诊断学] Q939.92[医药卫生—临床医学]