2013—2017年胶东地区流感嗜血杆菌耐药性监测  

Antibiotic resistance profile of haemophilus influenzae in Jiaodong region from 2013 to 2017

作　　者：李倩[1] 伊茂礼[1] 吴金英[1] LI Qian;YI Maoli;WU Jinying(Department of Clinical Laboratory,Yantai Yuhuangding Hospital,Yantai,Shandong 264000,Chin)

机构地区：[1]烟台毓璜顶医院检验科,烟台264000

出　　处：《国际检验医学杂志》2018年第A01期18-21,共4页International Journal of Laboratory Medicine

基　　金：烟台市重点研发计划项目（2016WS023）.

摘　　要：目的 对2013-2017年收集的烟台毓璜顶医院（山东省区域医疗中心）847株流感嗜血杆菌进行耐药性分析，了解胶东地区流感嗜血杆菌的耐药性及趋势变化。 方法 采用头孢硝噻吩纸片法测定β内酰胺酶,采用纸片扩散法进行药敏试验，按照CLSI2017版标准判断结果。 结果 流感嗜血杆菌分离率有升高趋势：2013年为2.54%，2014年为2.00%，2015年为2.07%，2016年为2.13%，2017年为3.06%。耐药情况以复方新诺明耐药率最高，5年来一直保持在80%以上。其他药物如氨苄西林、氨苄西林/舒巴坦、阿奇霉素，也表现出上升趋势。分别由2013年的68.6%、43.3%、37.9%上升到2017年的87.2%、51.4%、46.5%，头孢噻肟、环丙沙星、氧氟沙星、氯霉素，耐药率有所下降。流感嗜血杆菌标本来源以痰液为主，其中分离率儿童高于成人，住院患者高于门诊患者。 结论 流感嗜血杆菌对头孢菌素类、阿莫西林-克拉维酸、氯霉素及环丙沙星耐药率保持在较低水平，但阿奇霉素耐药率近5年有明显升高趋势而复方新诺明耐药率已经超过80%，不再适合临床用药。Objective ： To investigate the changing antibiotic resistance profile of 847 strains Haemophilus influenzae collected from yantai yuhuangding hospital（Shandong province regional medical center） from 2013 through 2017. Methods： Beta-lactamases were detected by nitrocefin disk test.Antimicrobial susceptibility testing was carried out according to a unified protocol using Kirby-Bauer method.Results were analyzed according to CLSI 2017 breakpoints. Results： The prevalence of H influenzae increased with time from 2.54% in 2013,2.00% in 2014,2.07% in 2015,2.13% in 2016 to 3.06% in 2017.The highest resistance rate was trimethoprim-sulfamethoxazole.which always stay above 80 percents in 5 years.The resistance rate to ampicillin,ampicillin-sulbactarn and azithromycin also increased from 68.6%,43.3% and 37.9% in 2013 to 87.2%, 51.4% and 46.5% in 2017,respectively.However.the resistance rate to cefotaxime,ciprofloxacin and chloramphenicol decreased in recent years.The source of H influenzae was mainly sputum,among which the separation rate of children was higher than that of adults.And the separation rate of hospitalized patients were higher than the outpatients. Conclusion ： H influenzae are still susceptible to cephalosporins,amoxicillin-clavulanic acid,chloramphenicol and ciprofloxacin.In the last five years,the drug resistance rate of azithromycin increased significantly.Over 80% of these strains were resistant to trimethoprim-sulfamethoxazole.So azithromycin and trimethoprim-sulfamethoxazole have been inappropriate for clinical therapy.

关 键 词：流感嗜血杆菌 耐药性 

分 类 号：R378.41[医药卫生—病原生物学]