成人呼吸道感染副流感嗜血杆菌生物学分型及耐药性  

Biotypes and antimicrobial resistance of Haemophilus parainfluenzae isolated from adults with respiratory tract infection

作　　者：隆丰厚 艾文卫 唐孝志 龚小省 陈烨 李武连 刘友生 

机构地区：[1]新邵县人民医院,湖南新邵422900 [2]邵阳市中心医院,湖南邵阳422000

出　　处：《中国感染控制杂志》2013年第5期381-383,共3页Chinese Journal of Infection Control

基　　金：湖南省卫生厅扶助县级医院科技项目(X2011-018)

摘　　要：目的了解某院成人呼吸道感染副流感嗜血杆菌的生物型,以及其与产β-内酰胺酶及耐药性的关系。方法收集该院2011年10月—2012年7月临床确诊为呼吸道感染患者（成人）的痰标本1 994份,进行嗜血杆菌分离培养;对分离的副流感嗜血杆菌进行鉴定、生物学分型、β-内酰胺酶试验和药敏试验。结果 1 994份痰标本共分离嗜血杆菌102株（5.12%）,其中副流感嗜血杆菌68株（66.67%）,流感嗜血杆菌20株（19.61%）,其他嗜血杆菌14株（13.72%）。副流感嗜血杆菌共检出Ⅰ~Ⅵ6种生物型,分别为：Ⅰ型42株,Ⅴ型14株,Ⅱ、Ⅵ型各4株,Ⅲ、Ⅳ型各2株;其中54株（79.41%）产β-内酰胺酶。副流感嗜血杆菌对氨苄西林、左氧氟沙星、四环素和复方磺胺甲口恶唑呈现较高的耐药率,分别为83.82%、60.29%、57.35%和70.59%;对头孢噻肟、氨苄西林/舒巴坦、头孢克洛、克拉霉素、利福平的耐药率分别为8.82%、13.24%、5.89%、20.58%和25.00%;尚未检出对亚胺培南、氯霉素耐药的菌株。各生物型副流感嗜血杆菌对抗菌药物的耐药性存在一定差异。结论副流感嗜血杆菌是该院成人呼吸道感染的常见病原菌之一,Ⅰ型和Ⅴ型为主要流行生物型;多数菌株为产β-内酰胺酶株,临床应重视副流感嗜血杆菌生物学及耐药性分型监测,防止耐药菌株流行。Objective To investigate the biotypes of Haemophilus parainfluenzae（H.parainfluenzae）isolated from adults with respiratory tract infection in a hospital and relationship of H.parainfluenzae with producing ofβ-lactamase and antimicrobial resistance.Methods 1 994 sputum specimens from adult patients with respiratory tract infection from October 2011to July2012 were taken for Haemophilusisolation and culture,the isolated H.parainfluenzae were identified,performed biotyping,β-lactamase detection and antimicrobial susceptibility testing.Results A total of 102 isolates（5.12%）of Haemophilus were isolated,68（66.67%）of which were H.parainfluenzae,20（19.61%）were Haemophilus influenzae,and 14（13.72%）were other types of Haemophilus.Six biotypes（Ⅰ-Ⅵ）were detected among H.parainfluenzae,typeⅠ,Ⅱ,Ⅲ,Ⅳ,Ⅴ,Ⅵ were 42,4,2,2,14,and 4 isolates,respectively.There were 54（79.41%）β-lactamase-producing isolates.H.parainfluenzae had higher resistance to ampicillin（83.82%）,levofloxacin（60.29%）,tetracycline（57.35%）,and sulfamethoxazole/trimethoprim（70.59%）.The resistant rates to cefotaxime,ampicillin/sulbactam,cefaclor,clarithromycin,and rifampicin was8.82%,13.24%,5.89%,20.58% and 25.00%,respectively;There were no strains resistant to imipenem and chloramphenicol.There were some differences in antimicrobial resistance among various biotypes.Conclusion H.parainfluenzaeis a common pathogen in adults with respiratory tract infection in this hospital,the major epidemic biotypes are typeⅠand V,most isolates produceβ-lactamase,detection of biotypes and antimicrobial resistance of H.parainfluenzae should be paid attention.

关 键 词：嗜血杆菌 副流感嗜血杆菌 呼吸道感染 生物学分型 Β-内酰胺酶 抗药性 微生物 

分 类 号：R378.4[医药卫生—病原生物学] R181.32[医药卫生—基础医学]