2013～2016年四川省儿童患者流感嗜血杆菌和卡他莫拉菌耐药性分析  

Antibiotic Resistance Analysis of Haemophilus Influenzae and Moraxella Catarrhalis Strains Isolated from Children in Sichuan Province from 2013 To 2016

作　　者：张琼芳[1] 王芳[1] 李睿[1] 任然[1] 吴波[1] 辛力华[1] ZHANG Qiong-fang;WANG Fang;LI Rui;REN Ran;WU Bo;XIN Li-hua(Department of Clinical Laboratory, the Affiliated Hospital of Chengdu University of TCM , Chengdu 610072, China)

机构地区：[1]成都中医药大学附属医院检验科,成都610072

出　　处：《现代检验医学杂志》2018年第2期38-41,45,共5页Journal of Modern Laboratory Medicine

摘　　要：目的了解2013~2016年四川省儿童患者临床分离流感嗜血杆菌和卡他莫拉菌的耐药性变迁,为临床抗菌药物合理利用提供一定的参考依据。方法收集2013~2016年四川省耐药监测报告的儿童患者所分离的流感嗜血杆菌和卡他莫拉菌的感染数据,实验结果采用WHONET5.6软件进行耐药率分析。结果 4年间,儿童流感嗜血杆菌检出率呈上升趋势:2013年为8.95%,2016年上升至16.66%;儿童卡他莫拉菌的检出率呈上升趋势,2013年为4.16%,2016年上升至6.34%。15 896株儿童流感嗜血杆菌对氨苄西林耐药率最高,2016年为71.6%;对头孢克洛的上升趋势更明显,由2013年的26.1%上升至2016年的59.5%,增幅为33.4%;对阿奇霉素不敏感率上升,由2013年的8.3%上升至2016年的25%,对头孢曲松、莫西沙星的不敏感率呈下降趋势,且对头孢曲松、头孢噻肟、左氧氟沙星、莫西沙星的敏感率各年均高于90%。与分离自所有患者的流感嗜血杆菌耐药率相比,分离自儿童患者流感嗜血杆菌耐药率更高,儿童分离株和总菌株对阿奇霉素的不敏感率呈逐年上升趋势,分别由2013年的8.3%,10.2%升至2016年的25%,22.1%。5 625株卡他莫拉菌对阿莫西林/克拉维酸、头孢曲松、头孢噻肟、左氧氟沙星、环丙沙星敏感率高,大于90%;对复方新诺明的耐药率逐年增高,由2013年的15.1%上升至59.1%。结论流感嗜血杆菌对第三代头孢菌素类敏感率大于90%,可作为临床首选药物,而对氨苄西林和复方新诺明的耐药率已上升至70%左右,不适于选用。儿童卡他莫拉菌对复方新诺明的耐药率上升至59.1%,对其它测试药物耐药率变化较小。Objective To investigate the changing antibiotic resistance profile of Haemophilus influenzae and Moraxella catarrhalis strains collected from children in Sichuan province from 2013 to 2016,provide some reference for rational utilization of clinical antimicrobial agents.Methods Collected the infection data of Haemophilusinfluenzaeand Moraxella catarrhalis strains isolated from children which reported in Sichuan Province Drug Resistance Monitoring Report from 2013 to 2016.The experimental results were analyzed by WHONET5.6 software.Results The prevalence of H.influenzae increased with time from 8.95% in 2013 to 16.6% in 2016.The prevalence of M.catarrrhalis increased with time from 4.16% in2013 to 6.34% in 2016.Among the 15 896 clinical strains of H.influenzae,the highest resistance rate was to ampicillin,which was 71.6% in 2016.The resistance rate to cefaclor also increased from 26.1%in 2013 to 59.5%in 2016 for increase of 33.4%.The insensitivity rate to azithromycin increased from 8.3% in 2013 to 25% in 2016.However,the insensitivity rate to ceftriaxone and moxifloxacin decreased in recent years and the susceptibility rate to ceftriaxone,cefotaxime,levofloxacin and moxifloxacin were higher than 90% in each year.The resistance rate of H.influenzae strains from children were higher than the stains from all patients.The insensitivity rate to azithromycin in strains from children and all patients increased from 8.3%,10.2%in 2013 to 25%,22.1%in 2016,respectively.The 5 625 clinical strains of M.catarrrhalis remained highly susceptible to the amoxicillin-clavulanic acid,ceftriaxone,cefotaxime,levofloxacin,ciprofloxacin（greater than90%）.The resistance rate to cotrimoxazole increased from 15.1%in 2013 to 59.1%in 2016.Conclusion H.influenzae are still susceptible to the third generation cephalosporins（greater than 90%）,which can be used as the first choice in clinical practice.Nearly 70% of these strains were resistant to ampicillin and cotrimoxazole,which is inappropriate for clinical therapy.The resistance rate

关 键 词：流感嗜血杆菌 卡他莫拉菌 耐药性 

分 类 号：R378[医药卫生—病原生物学] R446.5[医药卫生—基础医学]