摘要
目的了解流感嗜血杆菌(haemophilus influenza,HI)患儿分离株的耐药模式及流行特点,为临床经验治疗提供依据。方法 2007年1月至2014年12月浙江大学医学院附属儿童医院共检出HI菌株546株,98.7%的菌株来自呼吸道标本。男性患儿检出348株,女性198株,男女比例1.76∶1。年龄范围为7 d至13岁。HI培养采用嗜血杆菌专用培养基,菌株的鉴定采用Ⅴ因子和Ⅹ因子需求试验,药敏试验采用纸片扩散法,β内酰胺酶检测采用Cefinase纸片法。结果季节分布以春季为主,共331株(60.6%),秋季最少,仅23株(4.2%)。146株(26.7%)菌株β内酰胺酶阳性,菌株β内酰胺酶阳性率逐年上升。153株(28.0%)菌株对氨苄西林耐药。多重耐药株占60株(11.0%),最常见者为同时耐氨苄西林、复方磺胺甲恶唑和克拉霉素,β内酰胺酶阳性菌株多重耐药率显著高于阴性菌株(χ2=145.1,P<0.005)。结论浙江大学医学院附属儿童医院HI株主要来自呼吸道标本,感染患儿以1岁以内为主,每年2—5月为感染高峰季节,菌株对氨苄西林的耐药性有逐年上升趋势,对二代头孢菌素仍保持较高敏感性,其可作为经验治疗首先药物。
Objective To investigate the antibiotic resistance patterns and epidemiological features of Haemophilus influenzae （HI） strains, and to provide reference for choosing antibiotics in clinical treatment. Methods A total of 546 strains were identified from 2007 to 2014 in Children＇s Hospital, Zhejiang University School of Medicine and 98.7% were isolated from respiratory tract specimens. Three hundred and forty-eight isolates （63.7%） were from boys and the male-female ratio was 1.76： 1. The age of the infected children ranged from 7 days to 13 years. Haemophilus influenza strains were cultured in Haemophilus selective medium. All strains were identified with V factor and X factor requirement test and the drug-sensitivities tests were performed with disk diffusion method. Cefinase was used to detect β-1actamase. Results Most of the strains （331 isolates, 60.6%） were isolated in spring, while only 23 （4.2%） were isolated in autumn. The β-1actamase positive strains increased annually and the total rate was 26.7%（146）, and 28.0%（153 strains） were resistant to ampicillin. The multi-resistance strains were 60 （ 11.0% ） and the major multi-resistance type was those resistant to ampicillin, trimethoprim-sulfamethoxazole and clarithromycin at the same time, and the multi-resistance rate in β-1actamase-positive strains were significantly higher than that in 13- lactamase- negative strains （X^2 = 145.1, P 〈 0.005 ）. Conclusion Most of the Haemophilus infiuenzae strains are isolated from respiratory samples in children younger than 1 year old in our hospital, and the peak months were February, March, April and May. The resistance rate to ampicillin of HI strains has increased annually, whereas to the second generation of cephalosporin, HI strains are still sensitive and they can be used in clinical treatment as the first choice.
出处
《中国实用儿科杂志》
CSCD
北大核心
2016年第12期915-919,共5页
Chinese Journal of Practical Pediatrics
基金
国家自然科学研究基金(81273329)
关键词
流感嗜血杆菌
儿童
耐药性
Haemophilus influenzae
child
antibiotic resistance
