卡他莫拉菌临床分布及耐药性分析  

Clinical distribution and antimicrobial resistance of Moraxella catarrhalis

作　　者：张玲[1] 程方雄[2] 刘瑾[2] 杨宏伟[3] 

机构地区：[1]华中科技大学同济医学院附属普爱医院骨科,湖北武汉430033 [2]华中科技大学同济医学院附属普爱医院检验科,湖北武汉430033 [3]湖北医药学院附属太和医院检验科,湖北十堰442000

出　　处：《中华医院感染学杂志》2014年第3期545-546,共2页Chinese Journal of Nosocomiology

基　　金：湖北省武汉市卫生局基金资助项目(WX12D14)

摘　　要：目的分析卡他莫拉菌(MC)的临床分布特点及耐药现状,为抗感染治疗提供参考依据。方法收集医院2007年7月-2012年12月住院患者各种感染性标本,细菌培养和分离严格按照《全国临床检验操作规程》进行,采用法国生物梅里埃公司生产的VITEK-2Compact全自动微生物分析仪和配套鉴定试剂盒进行菌种鉴定;采用琼脂稀释法对抗菌药物进行敏感试验,并用头孢硝噻吩纸片检测β-内酰胺酶,数据统计应用WHONET 5.5软件处理分析。结果 55株MC在痰液和咽拭子中检出率最高,占74.5%,其次为耳分泌物占18.2%,眼结膜分泌物标本占7.3%;科室分布以儿科为主占50.9%,其次为呼吸科占21.8%;喹诺酮类抗菌药物对MC表现出较高的敏感性,左氧氟沙星为100.0%敏感,环丙沙星为98.2%,对阿莫西林/克拉维酸与克拉霉素保持着100.0%的抗菌活性,对氨苄西林的耐药率为92.7%。结论 MC不但可引起医院感染,而且可导致医院感染的暴发流行,因此医院务必要执行《抗菌药物临床应用管理办法》,重视MC的病原学检测。OBJECTIVE To analyze the clinical distribution and antimicrobial resistance of 55 strains of Moraxella catarrhalis （MC） so as to provide the reference for anti-infection treatment. METHODS The infective specimens were collected from the patients who were hospitalized from Jul 2007 to Dec 2012, then the bacterial culture and isolation were performed by referring to National Guide to Clinical Laboratory Procedures, VITEK compact 2 automatic microorganism identification system （bioMfrieux） and matching identification kit were employed to identify the species, then the drug susceptibility testing for 9 antibiotics was performed with the use of agar dilution method, the β-1actamase was detected by using nitrocefin disks, and the data were analyzed by using WHONET 5.5 software. RESULTS The detection rate of the 55 strains of MC isolated from the sputum and throat swab was the highest （74. 5%）, followed by the secretions from ears （18. 2%） and the secretions from eyes （7.3%）; 50. 9% of the strains were isolated from the pediatric department, 21. 8% from the respiratory department. The MC strains were highly susceptible to quinolones, the drug susceptibility rate to levofloxacin was 100.0%, ciprofloxaein 98.2 %; amoxicillin/clavulanic acid and clarithromycin maintained 100.0% of antibacterial activity against MC, and the drug resistance rate to amoxicillin was 92.7%. CONCLUSION The MC isolates can not only result in nosocomial infections, but also cause outbreaks and prevalence of the nosocomial infections, thus it is necessary for the hospital to implement the Clinical Application Management of Antibiotics and attach great importance to etiological assay.

关 键 词：卡他莫拉菌 耐药性 病原菌 Β-内酰胺酶 

分 类 号：R378[医药卫生—病原生物学]