儿童呼吸道分离流感嗜血杆菌的耐药性和基因分型  

Antimicrobial resistance profile and genotypes of Haemophilus influenzae isolates from respiratory tract in children

作　　者：秦惠宏 王春[2] 潘芬[2] 刘昌颀[2] 赵克温 张泓 

机构地区：[1]上海交通大学医学院基础医学院病理生理学教研室,上海200025 [2]上海交通大学附属儿童医院检验科

出　　处：《中国感染与化疗杂志》2017年第5期532-537,共6页Chinese Journal of Infection and Chemotherapy

基　　金：上海市卫计委重要薄弱学科建设(2015ZB0203)

摘　　要：目的研究儿童呼吸道分离流感嗜血杆菌的耐药性和该菌ftsI基因分型与耐药表型的关系。方法收集2016年第一季度住院患儿鼻咽吸出物中分离到的流感嗜血杆菌141株;用纸片扩散法检测细菌对抗菌药物的耐药性;用Nitrocefin纸片法检测细菌的β内酰胺酶;用PCR技术对分离菌株进行ftsI基因检测;比较不同基因型菌株对抗菌药物的耐药情况。结果141株流感嗜血杆菌β内酰胺酶检出率为40.4%(57/141)、氨苄西林耐药率为53.2%(75/141)。检出ftsI基因突变率为72.3%(102/141),以Ⅲ型为主(72/102,70.6%)。β内酰胺酶基因阴性氨苄西林耐药型菌株(g BLNAR)对氨苄西林和头孢呋辛的耐药率高于β内酰胺酶基因阴性氨苄西林敏感型菌株(g BLNAS)(P<0.05)。结论儿童呼吸道分离流感嗜血杆菌ftsI基因突变率高,以Ⅲ型为主。ftsI基因突变增加了流感嗜血杆菌对氨苄西林和头孢呋辛的耐药性。Objective To investigate the antibiotic resistance profile andftsI genotypes of Haemophilus influenzae isolates from respiratory tract in children. Methods A total of 141 consecutive nonduplicate clinical strains of H, influenzae were collected from January to March 2016. Antimicrobial susceptibility was determined using Kirby-Bauer method. Beta-lactamase production was detected by nitrocefin disk test. PCR technique was employed forfis! genotyping. Antimicrobial resistance was compared between differentfis[ genotypes. Results The prevalence of 13-1actamases was 40.4% （57/141） in 1-1. influenzae isolates. More than half （53.2%, 75/141） of the strains were resistant to ampicillin. Mutation offisI gene was positive in 72.3% （102/141） of the isolates. The dominant genotype of genomic beta-lactamase-negative ampicillin-resistant （gBLNAR） strains was type III （72/102, 70.6%）. The gBLNAR strains showed higher resistance rate to ampicillin and cefuroxime than the genomic beta-lactamase-negative ampicillin- susceptible （gBLNAS） strains （P〈0.05）. Conclusions High prevalence offtsI gene mutation is found in the strains ofH. influenzae isolated from respiratory tract in children. The dominant genotype of gBLNAR strains was type III. Mutation offlsI gene in H. influenzae is associated with higher resistance rate to ampicillin and cefuroxime.

关 键 词：流感嗜血杆菌 耐药性 ftsI基因 

分 类 号：R446.5[医药卫生—诊断学] R725.6[医药卫生—临床医学]