儿童感染流感嗜血杆菌的流行病学及耐药机制研究  

Epidemiology and resistant mechanism of Haemophilus influenzae isolated from children

作　　者：潘芬[1] 刘昌颀 王春[1] 秦惠宏[1] 张泓[1] 

机构地区：[1]上海交通大学附属儿童医院检验科,上海200040

出　　处：《中华医院感染学杂志》2016年第24期5700-5703,共4页Chinese Journal of Nosocomiology

基　　金：上海申康医院发展中心市级医院临床辅助科室能力建设项目(SHDC22014012)

摘　　要：目的探讨儿童流感嗜血杆菌耐药情况及对氨苄西林的耐药机制,为临床治疗提供参考依据。方法收集医院2012年-2013年呼吸道感染患儿分离到375株流感嗜血杆菌菌株,采用纸片扩散法和头孢硝噻吩纸片法分析其耐药性和β-内酰胺酶情况,聚合酶链反应(PCR)法检测耐氨苄西林菌株的β-内酰胺酶基因。结果流感嗜血杆菌对氨苄西林的耐药率为40.3%,对阿莫西林/克拉维酸、氨苄西林/舒巴坦、头孢呋辛、头孢噻肟等抗菌药物敏感率较高,均>70.0%;375株流感嗜血杆菌菌株中,检出119株产β-内酰胺酶,产酶率为31.7%,且氨苄西林耐药株中均检出TEM-1型基因,未发现ROB-1型基因。结论流感嗜血杆菌耐药情况不容忽视,应加强对其耐药性监测及耐药机制研究,为控制其感染传播提供参考。OBJECTIVE To investigate antimicrobial resistance and resistant mechanism of Haemophilus influenza to ampicillin in children,so as to provide evidence for clinical treatment.METHODS A total of 375 strains of H.influenzaisolated from children with respiratory infections from Shanghai Children′s Hospital from 2012 to 2013were collected.Antimicrobial resistance andβ-lactamase of H.influenzae were detected by Kirby-Bauer disk diffusion method and nitrocefin-based test.Theβ-lactamase genes were amplified by polymerase chain reaction（PCR）.RESULTS The antimicrobial resistant rate of H.influenzae to ampicillin was 40.3%,and the susceptibility rates to amoxicillin/clavulanic acid,ampicillin/sulbactam,cefuroxime and cefotaxime were all higher than70.0%.Of 375 isolates,119strains wereβ-lactamase positive,with the production rate of 31.7%,and TEM-1gene was detected in ampicillin-resistant strains,with no ROB-1gene positive being found.CONCLUSIONThe antimicrobial resistance of H.influenzae is serious,and their antimicrobial resistance monitoring and resistant mechanism should be strengthened,so as to provide references for the control of the infection spread.

关 键 词：流感嗜血杆菌 耐药性 Β-内酰胺酶 TEM-1基因 

分 类 号：R378.41[医药卫生—病原生物学]