呼吸道嗜血杆菌属的生物学分型及耐药性分析  

Biological typing and drug resistance analysis of Haemophilus strains from respiratory tract

作　　者：江秀爱 赵自云 姜蓓 乔显森 

机构地区：[1]山东省青岛市中心医院检验科,山东青岛266042

出　　处：《国际检验医学杂志》2015年第19期2840-2841,2843,共3页International Journal of Laboratory Medicine

摘　　要：目的了解该院临床分离嗜血杆菌属的季节分布、生物学分型及耐药性。方法收集呼吸道感染患者的痰液和咽拭子,采用手工法、MicSCAN4全自动细菌鉴定分析仪、HNID鉴定板对分离培养的221株嗜血杆菌进行菌种鉴定,并进行生物学分型。用纸片扩散(K-B)法进行药物敏感试验,采用头孢硝噻吩纸片法进行β-内酰胺酶检测。结果临床分离流感嗜血杆菌96株(占1.6%),生物Ⅰ型10株(10.4%),生物Ⅱ型31株(32.3%),生物Ⅲ型40株(41.7%),其他生物型15株(15.6%)。副流感嗜血杆菌125株(占2.1%),生物Ⅰ型15株(12.0%),生物Ⅱ型23株(18.4%),生物Ⅲ型69株(55.2%),生物Ⅳ型18株(14.4%),未检出其他生物型。冬季感染率最高。流感嗜血杆菌和副流感嗜血杆菌对氨苄西林耐药率分别为40.6%%和44.8%,对复方磺胺甲噁唑的耐药率分别为51.0%和66.4%。流感嗜血杆菌和副流感嗜血杆菌β-内酰胺酶株产酶率分别为40.6%和44.8%,对头孢呋辛、头孢噻肟、美罗培南、氯霉素的敏感率都在90.0%以上。结论呼吸道流感嗜血杆菌和副流感嗜血杆菌感染好发于冬季,感染的生物型均以生物Ⅱ型、Ⅲ型为主,对氨苄西林和复方磺胺甲噁唑的耐药率较高,已不宜用于嗜血杆菌引起感染的经验治疗。对该菌所致呼吸道感染可选用头孢呋辛、头孢噻肟、美罗培南作为治疗的首选药物。Objective To investigate season distribution,biological typing and drug resistant of Haemophitus in Qingdao Central Hospital. Methods The sputum and throat swab were collected from patients with respiratory tract infection, 221 Haemophilus strains were identified and typed by the manual method and MicSCAN4 automatic analyzer, HNID identification plate. Antimicrobial susceptibility was tested by Kirby-Bauer method, and cephalosporins nitrate thiophene paper method was used to detect β-lacta- masc. Results A total of 96 strains of Haemophilus influenzae（ 1.6 % ） were isolated, 10 （ 10.4 % ） strains of Haemophilus influenzae were identified as type [ ,31（32.3%）as type H,40（41.7%）as typeⅢand 15（15.6%） as other types. A total of 125 strains Hae- mophitus parl influenzae（2. 1 %） were isolated, 15 （12. 0%） strains of Haemophilus parl influenzae were identified as type Ⅰ, 23 （18.4%）as type Ⅱ ,69（55.2%）as type Ⅲ and 18（14.4%） as type Ⅳ ,other types were not identified. The highest infected rate was in winter. Resistance rate of Haemophilus influenzae and Haemophitus parl influenzae to ampicillin were 40.6 % and 44.80/00, to tri methoprim sulfarnethoxazole were 51.0% and 66.4%. The prevalence of β-lactamase of all strains were 40.6%and 44.8%. But sus ceptible rates of Haemophilus to cefotaxime,cefuroxime,meropenem,chloramphenicol were over 90.0%. Conclusion The respira tory tracl infections to Haemophilus influenzae and Haemophitus parl influenzae is more frequently found in winter. Type Ⅱ and type Ⅲ are the most prevalent types. The resistance rates of Haemophilus to ampicillin and trimethoprim sulfamethoxazole are increasing,should not be used as empirical treatment of Haemophilus infection. Antibiotics such as cefotaxime,cefuroxime,meropen em could be chosen for the treatment of respiratory tract infection caused by Haemophilus.

关 键 词：嗜血杆菌 耐药性 药物敏感试验 Β-内酰胺酶 生物学分型 

分 类 号：R446.5[医药卫生—诊断学]