引起学龄前儿童化脓性中耳炎流感嗜血菌生物学分型及耐药性分析  

Analysis of biology typing and drug resistance about Haemophilus infl uenzae among preschool children with otitis media

作　　者：段达荣[1] 张文喜[2] 喻长法[1] 张虹[1] 

机构地区：[1]浙江省台州市第一人民医院检验科,台州318020 [2]浙江省台州市第一人民医院儿科,台州318020

出　　处：《中国抗生素杂志》2014年第3期240-240,I0001-I0003,共4页Chinese Journal of Antibiotics

摘　　要：目的了解学龄前儿童中耳炎流感嗜血菌的感染情况，并对其进行分型及耐药性监测，为临床诊断和合理使用抗生素提供依据。方法取1103份学龄前儿童化脓性中耳炎的脓性标本进行流感嗜血菌培养，并对其进行生物学分型、β-内酰胺酶及药敏试验。结果1103份标本中检出86株流感嗜血菌，阳性率7．8％；年龄分布中3～4岁组构成比最高，占48．8％，5-6岁组最低，占21．0％。对流感嗜血菌进行生物学分型，结果以I、II、III型为主，分别为14．0％、24．4％、54．5％，未检出VII和VIII型；用Nitrocefin纸片进行β-内酰胺酶检测，有13株β-内酰胺酶阳性，阳性率15．1％（13／86），纸片法检测氨苄西林耐药率为17．4％（15／86）。流感嗜血菌对复方磺胺甲嗯唑、氨苄西林、氯霉素的耐药率分别为67．5％、17．4％、11．6％，对氨苄西林／舒巴坦、左氧氟沙星、阿奇霉素、头孢噻肟、头孢呋辛的耐药率分别为4．7％、4．7％、5．8％和7．0％。结论学龄前儿童化脓性中耳炎流感嗜血菌感染以2～4岁年龄组为主要人群，生物型以III型居多，药敏结果显示阿齐霉素、第二代和第三代头孢菌素及加酶抑制剂的β-内酰胺类抗生素耐药率较低，可作为学龄前儿童中耳炎流感嗜血菌治疗的经验用药。Objective To explore the infection status of Haemophilus injluenzae（Hi） among preschoolers with otitis media, and provide a scientific evidence for clinic diagnosis and using antibiotics by analyzing the biology typing and drug resistance. Methods 1103 specimen were collected from preschoolers with suppurative otitis media and cultivated, then carried on the biological type, β-lactamase and drug susceptibility test. Results 86 strains of Haemophilus injluenzae were isolated from 1103 samples with a positive rate of 7.8%, among the age distribution, the 3-4 age group was highest, with the positive rate being 48.8%, while the 5-6 age group was lowest, with the positive rate being 21.0%. According to the result of HI biology typing, HI type I, type II, type III were the most common strains, accounting for 14.0%, 24.4%, 54.5% respectively, while type VII and type VIII were not found. According to nitrocefin test, thirteen strains（15.1%） of β-lactamase were positive and drug resistance rate of ampicillin was 17.4%（ 15/86）. HI trimethoprimlsulfamethoxaxole, ampicillin and chloramphenicol resistance rate were 67.5%, 17.4%, 11.6%, while the resistance rate to ampicillin/sulbactam, levofloxacin, azithromycin, cefotaxime, cefuroxime was 4.7%, 4.7%, 5.8% and 7.0% respectively. Conclusion During the suppurative otitis media of Haemophilus influenzae infection among preschoolers, the 2-4 age group was the most common crowd and HI type III was the most common strains, and the drug susceptibility results showed that azithromycin, the second generation, third generations of cephalosporins and enzyme inhibitors of β-lactamase type were low in drug resistance, can be used as experience drugs for treating preschoolers with otitis media of Haemophilus influenzae.

关 键 词：化脓性中耳炎 流感嗜血菌 生物学分型 耐药性 

分 类 号：R378[医药卫生—病原生物学]