绍兴第二医院流感嗜血杆菌的耐药性分析
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摘要
目的分析绍兴第二医院从呼吸道标本中分离的流感嗜血杆菌(Haemophilus influenzae)的耐药情况,为临床医生治疗用药提供有效的依据。方法收集该院2016年1月-12月下呼吸道感染标本分离培养的流感嗜血杆菌,采用VITEK 2 Compact进行细菌鉴定,Kirby-Baue法进行药敏试验,头孢硝噻吩纸片法测定β-内酰胺酶。结果共分离到流感嗜血杆菌193株,阳性率最高的科室是肿瘤科,其次为呼吸内科、小儿科和监护室。流感嗜血杆菌对复方新诺明、氨苄西林和氨苄西林-舒巴坦的耐药率均高达55.0%以上,美罗培南和头孢噻肟对流感嗜血杆菌保持较好的抗菌活性,耐药率在10.0%以下。结论复方新诺明、氨苄西林和氨苄西林-舒巴坦应慎重用于流感嗜血杆菌感染的临床治疗。
Objective To analyze the antimicrobial resistance of Haemophilus influenzae isolated from the low respiratory tracts of patients at the Second Hospital of Shaoxing. Methods Haemophilus influenzae isolates were collected from the low respiratory tracts of patients from January 2016 to December 2016. The identification and antimicrobial susceptibility test for Haemophilus influenzae isolates were conducted by VITEK2 Compact full automated microbiology analyzer. The susceptibility test was carried out by the Kirby-Baue method,and β-lactamase was determined by the cephalosporin paper method. Results A total of 193 of H. influenzae isolates were obtained. The department with the highest positive rate was oncology,followed by respiratory medicine,pediatrics and intensive care unit. The resistance rates of Haemophilus influenzae to compound sulfamethoxazole,ampicillin and ampicillin-sulbactam were all above 55. 0%. Meropenem and cefotaxime maintained good antibacterial activity against Haemophilus influenzae,with the drug resistance below 10. 0%. Conclusion Trimethoprim/sulfamethoxazole,ampicillin and ampicillin-sulbactam should be cautiously used for treating infections caused by H. influenzae.
Objective To analyze the antimicrobial resistance of Haemophilus influenzae isolated from the low respiratory tracts of patients at the Second Hospital of Shaoxing. Methods Haemophilus influenzae isolates were collected from the low respiratory tracts of patients from January 2016 to December 2016. The identification and antimicrobial susceptibility test for Haemophilus influenzae isolates were conducted by VITEK2 Compact full automated microbiology analyzer. The susceptibility test was carried out by the Kirby-Baue method,and β-lactamase was determined by the cephalosporin paper method. Results A total of 193 of H. influenzae isolates were obtained. The department with the highest positive rate was oncology,followed by respiratory medicine,pediatrics and intensive care unit. The resistance rates of Haemophilus influenzae to compound sulfamethoxazole,ampicillin and ampicillin-sulbactam were all above 55. 0%. Meropenem and cefotaxime maintained good antibacterial activity against Haemophilus influenzae,with the drug resistance below 10. 0%. Conclusion Trimethoprim/sulfamethoxazole,ampicillin and ampicillin-sulbactam should be cautiously used for treating infections caused by H. influenzae.
引文
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[11]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.
[12]桂和翠,王中新,沈继录.48株流感嗜血杆菌耐药性分析及β-内酰胺酶基因检测[J].安徽医科大学学报,2012,47(1):56-59.
[13]吴敏,徐浩.流感嗜血杆菌致老年社区获得性肺炎的危险因素与耐药状况分析[J].中国卫生检验杂志,2016,26(24):3636-3641.
[14]陶琪,李永祥.学龄前儿童流感嗜血杆菌感染的流行病学特征与耐药性研究[J].中国卫生检验杂志,2016,26(14):2114-2117.
[15]徐燕,闫涛,彭蘡.儿童呼吸道感染流感嗜血杆菌的耐药性分析[J].继续医学教育,2014,28(2):25-26.
[2]张真,田磊.2011年湖北省流感嗜血杆菌耐药性分析[J].医药导报,2013,32(9):1239-1241.
[3]Clinical and Laboratory Standards Institute.M100-S24 Performance standards for antimicrobial susceptibility testing[S].CLSI,2014.
[4]鲁梅华,洪永富.脑膜炎败血黄杆菌致恶性肿瘤患者下呼吸道感染的临床分析[J].中国微生态学杂志,2014,26(8):935-937.
[5]叶满,文晓君.儿童流感嗜血杆菌感染分布及耐药性监测[J].现代预防医学,2014,41(11):2010-2011.
[6]刘东华,胡艳华.儿童呼吸道不可分型流感嗜血杆菌感染及耐药现状[J].中华全科医学,2014,12(8):1304-1308.
[7]杨晓华,谭南,林爱心,等.儿童呼吸道流感嗜血杆菌的耐药性分析[J].中国感染与化疗杂志,2014,14(5):436-439.
[8]张文芳,郑珊,李丁,等.肿瘤患者呼吸道感染嗜血杆菌的临床分布与耐药性分析[J].中国肿瘤临床,2012,39(17):1292-1293.
[9]Tap LL,Hu BJ,He LX,et al.Etiology and antimierobial resistance of community acquired pneumonia in adult patients in China[J].Chin Med J,2012,125(17):2967-2972.
[10]Herrera-Lara S,Fernández-Fabrellas E,Cervera-Juan A,et al.Do seasonal changes and climate influence the etiology of community acquired pneumonia[J].Arch Bronconeumol,2013,49(4):140-145.
[11]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.
[12]桂和翠,王中新,沈继录.48株流感嗜血杆菌耐药性分析及β-内酰胺酶基因检测[J].安徽医科大学学报,2012,47(1):56-59.
[13]吴敏,徐浩.流感嗜血杆菌致老年社区获得性肺炎的危险因素与耐药状况分析[J].中国卫生检验杂志,2016,26(24):3636-3641.
[14]陶琪,李永祥.学龄前儿童流感嗜血杆菌感染的流行病学特征与耐药性研究[J].中国卫生检验杂志,2016,26(14):2114-2117.
[15]徐燕,闫涛,彭蘡.儿童呼吸道感染流感嗜血杆菌的耐药性分析[J].继续医学教育,2014,28(2):25-26.