小儿下呼吸道流感嗜血杆菌感染的血清分型及耐药分析  

Serotyping and drug resistance analysis of Haemophilus influenzae in lower respiratory tract infections in children

作　　者：周凯[1] 李立群[1] 徐飞[2] 谢国锦[2] 王晓卫[2] 

机构地区：[1]南京医科大学附属南京儿童医院内科,江苏南京210008 [2]南京医科大学附属南京儿童医院检验科,江苏南京210008

出　　处：《现代预防医学》2016年第4期643-645,共3页Modern Preventive Medicine

基　　金：南京市医学科技发展项目(YKK13136)

摘　　要：目的分析南京地区下呼吸道流感嗜血杆菌(Hi)感染患儿的临床特征、血清分型及其对常用抗菌剂的耐药性。方法回顾性分析2014年1月至2014年12月经痰培养确诊为下呼吸道Hi感染的247例患儿临床资料,玻片凝集法进行血清分型试验,纸片扩散法(K-B法)进行常用抗菌药物敏感实验,E-test法测定最低抑菌浓度(MIC)。结果62.35%为1岁以内,69.23%为冬春季节发病;临床表现均有咳嗽,67例伴有发热;呼吸系统外并发症以消化系统、循环系统多见;血清型分布,不定型(NTHi)占48.18%,分型株以f型(18.22%)、a型(14.57%)居多,b型(0.81%)最少;Hi对阿奇霉素(99.19%)、红霉素(98.79%)及氨苄西林(80.57%)耐药率高。结论南京地区下呼吸道Hi感染患儿以1岁内婴幼儿发病率高,冬春季节发病常见;血清型分布以NTHi多见;对阿奇霉素、红霉素和氨苄西林抗菌剂耐药性高。Objective The study was conducted to analyze the clinical characteristics, serotypes, and drug resistance against common antibacterial agents of Haemophilus influenza （Hi） in lower respiratory tract infection in children in Nanjing. Methods Clinical data of 247 children with confirmed Hi infection diagnosed by sputum culture in the lower respiratory tract between January and December of 2014 were retrospectively analyzed. Serotyping was carried out by the slide agglutination method, drug susceptibility test was conducted by K-B method, and minimal inhibitory concentration （MIC） was determined by E-test. Results 62.35% of the cases were less than 1 year of age, and 69.23% of the infections occurred in winter and spring. Coughing was a common clinical symptom, and 67 of the cases also had fever. In addition to infection in the respiratory system, complications mostly occurred in the digestive system and circulatory system. In terms of serotype distribution, 48.18% was unidentified （NTHi） ; among the identified ones, type f （18.22%） and type a （14.57%） were dominant, and type b （0.81%） was the least common. Hi was highly resistant against azithromycin （99.19%）, erythromycin （98.79%）, and ampicillin （80.57%）. Conclusion Incidence of lower respiratory tract infection with Hi is high in Nanjing in children less than 1 year of age and in winter and spring. The most common serotype is NTHi. The Hi is highly resistant against azithromycin, erythromycin, and ampicillin.

关 键 词：流感嗜血杆菌 下呼吸道 血清型 耐药性 儿童 

分 类 号：R174[医药卫生—妇幼卫生保健]