2009-2013年重庆地区儿童感染流感嗜血杆菌的耐药性及血清型分析.docVIP

2009-2013年重庆地区儿童感染流感嗜血杆菌的耐药性及血清型分析 景春梅，王偲（400014重庆，重庆医科大学附属儿童医院检验科，儿童发育疾病研究教育部重点实验室，儿科学重庆市重点实验室，重庆市儿童发育重大疾病诊治与预防国际科技合作基地，） [摘要] 目的 了解2009-2013年重庆地区儿童感染流感嗜血杆菌(Haemophilus influenzae，Hi)的耐药性及血清型，为临床治疗Hi感染和推广Hi疫苗接种提供参考依据。方法 纸片扩散法检测Hi的耐药性，玻片凝集法对Hi进行血清分型。结果 共分离Hi 5474株，以呼吸道标本多见，占97.4%(5329株) 。6月～3岁组和3～5岁组的Hi分离率分别为21.8%和16.3%，高于6月组和5岁组的分离率10.3%和6.6%，82.2%的分离株在≤5岁年龄段；复方新诺明、氨苄西林、头孢噻肟、氨苄西林/舒巴坦、左氧氟沙星的耐药率分别为77.0%、42.4%、0.2 %、2.3%、0.4%。2009-2013年Hi对复方新诺明、阿莫西林/棒酸、氨苄西林、氯霉素、利福平、头孢呋辛、阿齐霉素耐药率有明显改变（P0.05），其余受试药物的耐药率均无明显改变（P0.05）。共分离出33株β-内酰胺酶阴性氨苄西林耐药Hi，占0.6%。2282株Hi产β-内酰胺酶，产酶率为41.7%。不可分型Hi占92.8%，可分型Hi中a型、b型、c型各占5.6%，d型、e型、f型分别为27.8%、38.9%、16.7%。结论 ≤5岁儿童是Hi感染易感人群，Hi主要分离自呼吸道标本，复方新诺明已不宜用于Hi感染的经验用药，临床应重视Hi的耐药现象，并加强Hi对抗菌药物的耐药性监测。血清分型以不可分型株为主，Hie是重庆地区儿童Hi的主要血清型。 [关键词] 流感嗜血杆菌；耐药性；血清型；β-内酰胺酶；儿童 [中图法分类号] R446.5,Q939.92,R378.4+1 [文献标识码] A Antimicrobial resistance and serotype of Haemophilus influenzae isolates from Chongqing children duringin Chongqing from 2009 to 2013 Jing Chunmei, Wang Cai （The (Department of Laboratory Medicine, Key Laboratory of Child Development Disease Research of Ministry of Education, Chongqing Key Laboratory of Pediatrics, Chongqing International Science and Technology Cooperation Base of Diagnosis, Treatment and Prevention for Children Development Major Diseases, the Children’s Hospital of Chongqing Medical University, Chongqing,/Child Development Disease Research, Ministry of Education Key Laboratory/Chongqing Key Laboratory of Pediatrics/Chongqing child development major disease diagnosis, treatment and prevention of the International Science and Technology Cooperation Base 400014, China) [Abstract] Objective To investigate the antimicrobial resistance and serotype of Haemophilus influenzae (Hi) isolates from the children in Chongqing fromduring the year of 2009 to 2013, and provide instruction for preventionation and pharmacological application. Methods Antimicrobial susceptibility testing was performed by Kirby-Bauer disc diffusion me