2017年聊城地区流感嗜血杆菌耐药分析
|
摘要
目的本研究对2017年聊城市第二人民医院收治的流感嗜血杆菌阳性病例进行了耐药分析,了解2017年聊城地区流感嗜血杆菌耐药性状况,为指导临床合理用药提供依据。方法通过全自动鉴定技术对病例的痰液进行鉴定,并对流感嗜血杆菌阳性病例进行菌株分离和耐药分析。结果本研究共分离到110例流感嗜血杆菌,79.05%的菌株呈现β-内酰胺酶阳性且对氨苄西林耐药,所有的分离株对阿奇霉素、美罗培南和亚胺培南敏感。发现第三代头孢菌素头孢噻肟、头孢他啶、头孢曲松的敏感率分别为96.36%、98.18%、98.18%,喹诺酮类环丙沙星、左氧氟沙星的敏感率分别为96.36%、98.18%。对复方磺胺甲恶唑和四环素的耐药比率较高,敏感率分别为21.81%和30.9%。结论聊城地区流感嗜血杆菌对一代和二代头孢菌素耐药呈上升趋势。
Objective Drug resistance analysis of Haemophilus influenzae in positive cases admitted to The Second People's Hospital of Liaocheng in 2017 was conducted to understand the drug resistance of Haemophilus influenzae in Liaocheng in 2017, so as to provided basis for guiding clinical rational drug use. Methods The sputum of cases was identified by automatic identification technology, and strain isolation and drug resistance analysis were carried out on Haemophilus influenzae cases. Results In this study, 110 strains of Haemophilus influenzae were isolated. Most of the strains(79.05%) produced β-lactamase, which coincide with a resistance. All the isolates were sensitive to azithromycin, meropenem and imipenem. Slight resistance were found towards third-generation cephalosporins(Cefotaxime, Ceftazidime, and Ceftriaxone), Quinolones(ciprofloxacin and levofloxacin), with sensitivity of 96.36%, 98.18%, 98.18%, 96.36% and 98.18%, respectively. High resistance were found towards compound sulfamethoxazole and tetracycline, with sensitivity of 21.81% and 30.9%, respectively. Conclu￣sion Haemophilus influenzae isolated in this study showed obviously increased resistance to fist-and second-generation cephalosporins.
Objective Drug resistance analysis of Haemophilus influenzae in positive cases admitted to The Second People's Hospital of Liaocheng in 2017 was conducted to understand the drug resistance of Haemophilus influenzae in Liaocheng in 2017, so as to provided basis for guiding clinical rational drug use. Methods The sputum of cases was identified by automatic identification technology, and strain isolation and drug resistance analysis were carried out on Haemophilus influenzae cases. Results In this study, 110 strains of Haemophilus influenzae were isolated. Most of the strains(79.05%) produced β-lactamase, which coincide with a resistance. All the isolates were sensitive to azithromycin, meropenem and imipenem. Slight resistance were found towards third-generation cephalosporins(Cefotaxime, Ceftazidime, and Ceftriaxone), Quinolones(ciprofloxacin and levofloxacin), with sensitivity of 96.36%, 98.18%, 98.18%, 96.36% and 98.18%, respectively. High resistance were found towards compound sulfamethoxazole and tetracycline, with sensitivity of 21.81% and 30.9%, respectively. Conclu￣sion Haemophilus influenzae isolated in this study showed obviously increased resistance to fist-and second-generation cephalosporins.
引文
[1] 吴丽华.流感嗜血杆菌研究的现状[J].中华流行病学杂志,1995,16(3):175-177.
[2] 王运中,季伟,陶云珍,等.儿童呼吸道感染流感嗜血杆菌的生物学分型及耐药性[J].江苏医药,2012,38(7):777-779.
[3] Murphy TF,Faden H,Bakaletz LO,et al.Nontypeable Haemophilus influenzae as a pathogen in children[J].Pediat Infect Dis J,2009,28(1):43-48.
[4] Song JH,Oh WS,Kang CI.Epidemiology and clinical outcomes of community-acquired pneumonin in adult pateents in Asian countrees:aprospective study by the Asian network for surveillanceof resistant pathogens[J].Antimicrob Agents,2008,31(2):107-104.
[5] Harabuchi Y,Faden N,Yamanaka L,et al.Nasopharyngeal colonization with nontypeable Haemophilus influenzae and recurrent otitis media[J].Infect Dis,1994,70(4):862-866.
[6] Touati A,Achour W,Ben Hassen A.Phenotypic and molecular characterization of beta-lactams resistance and capsular typing of colonizing Haemophilus influenzae strains isolated from neutropenic patients in Tunisia[J].Pathol Biol(Paris),2009,57(5):353-357.
[7] 胡莹,夏晓玲,黄海林,等.昆明地区儿童下呼吸道感染流感嗜血杆菌分离株的耐药性和血清分型研究[J].实验与检验医学,2013,31(2):118-120.
[8] 王炜,许淑珍.2004～2007年医院血培养病原菌的种类及耐药性变迁[J].陕西医学杂志,2011,40(2):188-191.
[9] 田磊,张真,陈中举,等.某院流感嗜血杆菌耐药性及其对氨苄西林耐药机制[J].中国感染控制杂志,2015,14(2):73-76.
[10] 马云华,张志军.流感嗜血杆菌的耐药性分析及分布情况[J].国际检验医学杂志,2016,37(20):2876-2878.
[11] 牛翠,张辉,杨启文.2008-2011年北京协和医院流感嗜血杆菌耐药性监测[J].中国感染与化疗杂志,2013,13(6):476-480.
[12] 孙燕,孔菁,张泓,等.2005年CHINET流感嗜血杆菌和卡他莫拉菌耐药性监测[J].中国感染与化疗杂志,2016,16(2):153-159.
[13] 裘益辉,张艳,华春珍,等.杭州市上呼吸道感染患儿分离的流感嗜血杆菌分离株的血清分型及其对氨苄西林的耐药分析[J].中国当代儿科杂志,2009,11(3):217-220.
[14] 张泓,孔菁,王传清,等.2010 中国 CHINET 流感嗜血杆菌和卡他莫拉菌耐药性监测[J].中国感染与化疗杂志,2012,12(3):180-184.
[15] Ohkusu K,Nakamura A,Sawada K.Antibiotic resistance among recent clinical isolates of Haemophilus influenzae in Japanese children[J].Diagn Microbiol Infect Dis,2000,36(4):249-254.
[16] 陶云珍,丁云芳,张建华,等.苏州地区儿童感染流感嗜血杆菌β-内酰胺酶基因检测[J].中国抗感染与化疗杂志,2005,5(2):108-110.
[17] 漆涌,伍勇,陶莹,等.长沙地区呼吸道感染流感嗜血杆菌的分子流行病学特征及耐药性分析[J].中国抗生素杂志,2008,33(11):701-703.
[18] 赵蕾.57株流感嗜血杆菌的耐药性分析及分布[J].中华实验和临床感染病杂志,2013,7(4):42-44.
[2] 王运中,季伟,陶云珍,等.儿童呼吸道感染流感嗜血杆菌的生物学分型及耐药性[J].江苏医药,2012,38(7):777-779.
[3] Murphy TF,Faden H,Bakaletz LO,et al.Nontypeable Haemophilus influenzae as a pathogen in children[J].Pediat Infect Dis J,2009,28(1):43-48.
[4] Song JH,Oh WS,Kang CI.Epidemiology and clinical outcomes of community-acquired pneumonin in adult pateents in Asian countrees:aprospective study by the Asian network for surveillanceof resistant pathogens[J].Antimicrob Agents,2008,31(2):107-104.
[5] Harabuchi Y,Faden N,Yamanaka L,et al.Nasopharyngeal colonization with nontypeable Haemophilus influenzae and recurrent otitis media[J].Infect Dis,1994,70(4):862-866.
[6] Touati A,Achour W,Ben Hassen A.Phenotypic and molecular characterization of beta-lactams resistance and capsular typing of colonizing Haemophilus influenzae strains isolated from neutropenic patients in Tunisia[J].Pathol Biol(Paris),2009,57(5):353-357.
[7] 胡莹,夏晓玲,黄海林,等.昆明地区儿童下呼吸道感染流感嗜血杆菌分离株的耐药性和血清分型研究[J].实验与检验医学,2013,31(2):118-120.
[8] 王炜,许淑珍.2004～2007年医院血培养病原菌的种类及耐药性变迁[J].陕西医学杂志,2011,40(2):188-191.
[9] 田磊,张真,陈中举,等.某院流感嗜血杆菌耐药性及其对氨苄西林耐药机制[J].中国感染控制杂志,2015,14(2):73-76.
[10] 马云华,张志军.流感嗜血杆菌的耐药性分析及分布情况[J].国际检验医学杂志,2016,37(20):2876-2878.
[11] 牛翠,张辉,杨启文.2008-2011年北京协和医院流感嗜血杆菌耐药性监测[J].中国感染与化疗杂志,2013,13(6):476-480.
[12] 孙燕,孔菁,张泓,等.2005年CHINET流感嗜血杆菌和卡他莫拉菌耐药性监测[J].中国感染与化疗杂志,2016,16(2):153-159.
[13] 裘益辉,张艳,华春珍,等.杭州市上呼吸道感染患儿分离的流感嗜血杆菌分离株的血清分型及其对氨苄西林的耐药分析[J].中国当代儿科杂志,2009,11(3):217-220.
[14] 张泓,孔菁,王传清,等.2010 中国 CHINET 流感嗜血杆菌和卡他莫拉菌耐药性监测[J].中国感染与化疗杂志,2012,12(3):180-184.
[15] Ohkusu K,Nakamura A,Sawada K.Antibiotic resistance among recent clinical isolates of Haemophilus influenzae in Japanese children[J].Diagn Microbiol Infect Dis,2000,36(4):249-254.
[16] 陶云珍,丁云芳,张建华,等.苏州地区儿童感染流感嗜血杆菌β-内酰胺酶基因检测[J].中国抗感染与化疗杂志,2005,5(2):108-110.
[17] 漆涌,伍勇,陶莹,等.长沙地区呼吸道感染流感嗜血杆菌的分子流行病学特征及耐药性分析[J].中国抗生素杂志,2008,33(11):701-703.
[18] 赵蕾.57株流感嗜血杆菌的耐药性分析及分布[J].中华实验和临床感染病杂志,2013,7(4):42-44.