儿童呼吸道感染流感嗜血菌的生物学分型与耐药性分析  

Biological typing of Haemophilus influenzae causing respiratory tract infections in children and analysis of drug resistance

作　　者：张大坤[1] 刘芬[1] 梁宁[1] 焦应念 钟磊 

机构地区：[1]解放军第371中心医院感染科,河南新乡453000 [2]桐乡市中医院感染科,浙江桐乡314500

出　　处：《中华医院感染学杂志》2015年第9期2114-2116,共3页Chinese Journal of Nosocomiology

基　　金：浙江省医药卫生计划基金资助项目(2011KYB124)

摘　　要：目的对儿童呼吸道感染流感嗜血菌的生物学分型及耐药性进行探究,为临床更好的预防和治疗提供参考。方法选取2012年11月-2013年11月276例呼吸道感染患儿,采集其呼吸道分泌物作为样本进行培养,并对其中的流感嗜血菌进行分离和分型鉴定;采用纸片法进行β-内酰胺酶测定,采用琼脂扩散法对流感嗜血菌的耐药性进行分析。结果 276份标本中分离出流感嗜血菌89株,检出率为32.2%;检出菌株主要为Ⅲ型和Ⅳ型,分别占37.1%、40.4%,无Ⅰ、Ⅵ型和Ⅷ型,各型β-内酰胺酶的产酶率为Ⅱ型40.0%、Ⅲ型42.4%、Ⅳ型36.1%、Ⅴ型28.6%和Ⅶ型25.0%;耐药性试验结果显示,各型流感嗜血菌对环丙沙星、头孢曲松、美罗培南的耐药性为0,对其他抗菌药物均有不同程度的耐药,其中对磺胺甲噁唑/甲氧苄啶的耐药率最高,为41.6%。结论流感嗜血菌最主要的是Ⅲ型和Ⅳ型,各型菌株的产β-内酰胺酶率均较高,耐药性相比以往有所提高,防治形势严峻。OBJECTIVEToexplorethebiologicaltypingof Haemophilusinfluenzaecausingrespiratorytractinfec‐tions in children and analyze the drug resistance so as to provide guidance for clinical prevention and treatment . METHODS From Nov 2012 to Nov 2013 ,a total of 276 children with respiratory tract infections were enrolled in the study ,then the respiratory tract secretions were collected for bacterial culture ,the H .inf luenzae strains were isolated ,the types were indentified ,theβ‐lactamases were determined by using disk method ,and the drug resist‐ance of the H .inf luenzae strains was analyzed with the use of agar diffusion method .RESULTS Totally 89 strains of H .inf luenzae were isolated from the 276 specimens ,with the detection rate of 32 .2% ;the type Ⅲ and type Ⅳwere the major types of the strains ,accounting for 37 .1% and 40 .4% ,respectively ;no strain of type Ⅰ ,Ⅵ ,orⅧ was found .The positive rates of the β‐lactamase‐producing type Ⅱ ,Ⅲ ,Ⅳ ,Ⅴ ,and Ⅶ H .influenzae strains were 40 .0% ,42 .4% ,36 .1% ,28 .6% ,and 25 .0% ,respectively .The results of the drug resistance testing indi‐cated that the drug resistance rates of the H .inf luenzae strains to ciprofloxacin ,ceftriaxone ,and meropenem were 0 ,the strains varied in the drug resistance to other antibiotics ,and the drug resistance rate to sulfamethox‐azole‐trimethoprimwasthehighest（41.6% ）.CONCLUSIONThetype Ⅲ andtype Ⅳ H.influenzaearethemost prevalent ,the positive rate of theβ‐lactamases is high in all types of strains .The drug resistance is increasingly se‐rious to certain extent ,making the prevention situation harsh .

关 键 词：儿童 呼吸道感染 流感嗜血菌 分型 耐药性 

分 类 号：R562.1[医药卫生—呼吸系统]