儿童呼吸道卡他莫拉菌感染状况及耐药性和耐药基因的研究  

Study on the Infection Status,Drug Resistance and Drug Resistance Genes of Moraxella Catarrhalis in Children with Respiratory Tract Infection

作　　者：杨晓华[1] 王桂兰[1] 汪伟山[1] 谭南[1] 林爱心[1] 陈燕辉[1] 

机构地区：[1]南方医科大学附属中山市博爱医院,中山528400

出　　处：《国外医药（抗生素分册）》2017年第2期72-75,共4页World Notes on Antibiotics

基　　金：广东省中山市科技局项目(2014A1FC053)

摘　　要：目的探讨儿童呼吸道感染卡他莫拉菌流行病学特点及其耐药性的现状,研究产β-内酰胺酶株耐药基因特征,指导临床诊断及治疗。方法对2014年3月—2015年2月份本院儿科门诊和住院部下呼吸道感染患儿的痰标本进行卡他莫拉菌分离培养,并进行鉴定及药敏试验。PCR扩增结合限制内切酶分析方法对分离株进行bro基因分型。结果(1)卡他莫拉菌分离率为13.50%,主要多见于4岁以下患儿,冬季为高发,混合感染率为46.20%,以混合肺炎链球菌最为多见。(2)分离的840株卡他莫拉菌的β-内酰胺酶的阳性率为92.50%,其中对阿莫西林/克拉维酸、复方磺胺甲恶唑、四环素的敏感性高达90%以上,但对红霉素、克拉霉素、阿奇霉素的非敏感性也在30%以上。(3)卡他莫拉菌bro基因分型结果:63株(7.50%)bro阴性,577株(68.70%)bro-1阳性,200株(23.81%)bro-2阳性。结论儿童呼吸道卡他莫拉菌的感染与年龄、季节有关,合并多种细菌的混合感染率较高,此次检出的卡他莫拉菌呈高产β-内酰胺酶,以携带bro-1基因为主。临床诊疗要密切监测卡他莫拉菌感染的流行病学特点及耐药情况。objective To explore the epidemiological characteristics and drug resistance of Moraxella Catarrhalis in children with respiratory tract infection, study the characteristics of drug resistance gene in β-lactamase- positive Moraxella Catarrhalis, and provide guidance for clinical diagnosis and treatment. Methods The sputum samples of children with lower respiratory tract infection in pediatric outpatient and inpatient were collected from March 2014 to February 2015, and the bacterial species and their drug sensitivity were determined. The bro genotyping of isolate was identified using PCR and restriction enzyme zymogram analysis. Results （1） The isolating rate of Moraxella catarrhalis was 13.50%, it was maily found in children under 4 years old, Moraxella catarrhalis had high isolating rate in winter, and the mixed infection rate reached 46.20%, Streptococcus pneumoniae was the most common pathogen that caused mixed infection with Moraxella catarrhalis. （2） The β-1actamase positive rate of Moraxella catarrhalis from 840 isolates was 92.50%, and the sensitivity of β-lactamase-positive Moraxella catarrhalis to amoxicillin/clavulanic acid, trimethoprim/sulfamethoxazole and tetracycline was over 90%, but more than 30% of them were non-sensitive to erythromycin, clarithromycin and azithromycin. （3） The results of bro genotyping to Moraxella catarrhalis： 63 isolates（7.50%） were bro gene negative, 577 isolates（68.70%） were bro-1 gene positive. 200 isolates（23.81%） were bro-2 gene positive. Conclusion The infection rate of Moraxella catarrhalis in children with respiratory tract infection is related with age and season, with high mixed infection rate. Moraxella catarrhalis is highly β-lactamase-positive, which mainly carries bro-1 gene. Epidemiological characteristics and drug resistance status of Moraxella catarrhalis should be closely monitored in clinical diagnosis and treatment.

关 键 词：儿童 卡他莫拉菌 耐药性 bro基因 

分 类 号：R725.6[医药卫生—儿科]