[1]赵智凝,张 伟,张小龙,等.2015-2019 年儿童呼吸道感染嗜血杆菌分离检出及耐药性变迁分析[J].现代检验医学杂志,2020,35(03):133-137.[doi:10.3969/j.issn.1671-7414.2020.03.036]
 ZHAO Zhi-ning,ZHANG Wei,ZHANG Xiao-long,et al.Detection and Drug Resistance of Haemophilus in Children’s Respiratory Tract Infection[J].Journal of Modern Laboratory Medicine,2020,35(03):133-137.[doi:10.3969/j.issn.1671-7414.2020.03.036]
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2015-2019 年儿童呼吸道感染嗜血杆菌分离检出及耐药性变迁分析()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第35卷
期数:
2020年03期
页码:
133-137
栏目:
检验与临床
出版日期:
2020-07-20

文章信息/Info

Title:
Detection and Drug Resistance of Haemophilus in Children’s Respiratory Tract Infection
文章编号:
1671-7414(2020)03-133-05
作者:
赵智凝张 伟张小龙王小艳
(中国人民解放军空军第九八六医院,西安 710054)
Author(s):
ZHAO Zhi-ning ZHANG Wei ZHANG Xiao-long WANG Xiao-yan
(Air Force 986 Hospital, PLA, Xi’an 710054, China)
关键词:
儿童嗜血杆菌β- 内酰胺酶氨苄西林耐药
分类号:
R378.4;R446.5
DOI:
10.3969/j.issn.1671-7414.2020.03.036
摘要:
目的 探讨儿童呼吸道嗜血杆菌的感染情况及耐药性变迁,为临床合理用药提供参考。方法 对2015 年1 月 ~2019 年12 月儿科门诊就诊及住院患儿痰标本中分离的233 株嗜血杆菌属细菌的临床感染特征及药敏试验结果进行回 顾性分析。结果 嗜血杆菌的总检出率为5.1%(233/4575),其中副流感嗜血杆菌51.1%(119/233),流感嗜血杆菌 36.9%(86/233),溶血嗜血杆菌6.4%(15/233)、惰性嗜血杆菌3.0%(7/233)和嗜沫嗜血杆菌2.6%;流感嗜血杆菌 和副流感嗜血杆菌对氨苄西林和复方新诺明耐药率均超过60%,耐药率呈逐年上升趋势;对头孢哌酮/ 舒巴坦及第三、 四代头孢菌素、左氧氟沙星、亚胺培南和阿奇霉素敏感率均大于70%;总β- 内酰胺酶阳性率为44.9%,产酶株全部对 氨苄西林耐药,产酶阴性株中氨苄西林耐药率为22%。结论 嗜血杆菌在儿童呼吸道标本中的检出率较高,对临床常 用抗菌药物耐药率呈逐年上升趋势,临床应根据药敏试验数据合理应用抗生素才能减缓耐药菌株产生。
Abstract:
Objective To explore the infection characteristics and drug resistance of Haemophilus in children’s respiratory tract in their hospital from January 2015 to December 2019. Methods The infection characteristics of 233 Haemophilus isolated from sputum samples of outpatients and inpatients in pediatrics were summarized and the antimicrobial sensitivity test results were analyzed. Results The total detection rate of Haemophilus was 5.1%, including Haemophilus parainfluenzae 51.1% (119/233), Haemophilus influenzae 36.9%(86/233), Haemophilus haemolyticus 6.4%(15/233), Haemophilus inert 3.0%(7/233) and Haemophilus foamus 2.6%(6/233). The drug resistance rate of Haemophilus influenzae and Haemophilus parainfluenzae to ampicillin and compound sulfamethoxazole was more than 60%, and the drug resistance rate showed an increasing trend year by year. The sensitivity rate of Haemophilusinfluenzae to Cefoperazone / sulbactam, third and fourth generation cephalosporins, levofloxacin, imipenem and azithromycin was more than 70%. The positive rate of total β - lactamase was 44.9%, and all the positive strains were resistant to ampicillin. Among the negative strains of β-lactamase, the drug resistant rate to ampicillin was 22%. Conclusion  The detection rate of Haemophilus in children’s respiratory tract specimens was high, and the resistance rate to commonly used antibiotics was increasing year by year. The rational use of antibiotics should be based on the data of drug sensitivity test to slow down the production of bacterial resistance.

参考文献/References:

[1] 张琼芳,王芳,李睿,等. 2013~2016 年四川省儿童 患者流感嗜血杆菌和卡他莫拉菌耐药性分析[J]. 现 代检验医学杂志, 2018, 33 (2) :38-41,45.    ZHANG Qiongfang, WANG Fang, LI Rui, et al. Antibiotic resistance analysis of Haemophilus influenzae and Moraxella catarrhalis strains isolated from children in Sichuan province from 2013 to 2016[J]. J Mod Lab Med, 2018, 33 (2) : 38-41,45.
[2] 雷旻, 周高枫, 王红梅, 等. 某儿童医院感染病房 病原菌分布及耐药性分析[J]. 国际检验医学杂志, 2016, 37 (19) : 2702-2704,2707.    LEI Min, ZHOU Gaofeng, WANG Hongmei, et al. The distribution and resistance of bacteria isolated from infection department of children’s hospital [J]. International Journal of Laboratory Medicine, 2016, 37 (19) : 2702-2704,2707.
[3] ESCRIBANO MONTANER A, GARCIA DE LOMAS J, VILLA ASENSI J R,et a1. Bacteria from bronchoalveolar lavage fluid from children with suspected chronic lower respiratory tract infection: results from a multi-center,cross-sectional study in Spain[J]. Eur J Pediatr, 2018,177 (2) : 181-192.
[4] 李娟,李艳,李丛荣,等. 儿童呼吸道感染肺炎链 球菌、流感嗜血杆菌检出情况及耐药性变迁[J]. 儿 科药学杂志, 2016, 22 (12) : 34-37.    LI Juan, LI Yan, LI Congrong, et al. Detection and antimicrobial resistance of Streptococcus pneumoniae and Haemophilus influenzae in Children’s respiratory tract infection[J]. Journal of Pediatric Pharmacy, 2016, 22 (12) : 34-37.
[5] UBUKATA K, MOROZUMI M, SAKUMA M, et al. Etiology of acute otitis media and characterization of Pneumococcal isolates after introduction of 13-valent Pneumococcal conjugate vaccion in Japanese children[J]. Pediatr Infect Dis J, 2018, 37 (6) : 598-604.
[6] 李志浩, 李巍, 田冬冬. 2018 年河南省儿童医院儿 童流感嗜血杆菌耐药性研究[J]. 医学检验与临床, 2019, 30 (9) : 13-16.    LI Zhihao, LI Wei, TIAN Dongdong. Study on drug resistance of Haemophilus influenzae in children from Henan Children’s Hospital in 2018[J]. Medical Laboratory Science and Clinics, 2019, 30 (9) : 13-16.
[7]  蔡淑梅, 陈保锦, 朱海平, 等. 临床标本嗜血菌 BLNAR 菌株的分离及其耐药性[J]. 中国抗生素杂 志, 2015, 40 (2) : 137-140.    CAI Shumei, CHEN Baojin, ZHU Haiping, et al. A surveillance report of detection rate and antimicrobial resistance to clinical isolates of BLNAR[J]. Chinese Journal of Antibiotics, 2015, 40 (2) : 137-140.
[8]  LI Jianping,HUA Chunzhen,SUN Liying,et a1. Epidemiological features and antibiotic resistance patterns of Haemophilus influenzae originating from respiratory tract and vaginal specimens in pediatric patients[J].J Pediatr Adolesc Gynecol,2017,30(6):626-631.
[9]  秦惠宏, 王春, 潘芬, 等. 儿童分离流感嗜血杆菌的 耐药性及β- 内酰胺酶基因分型[J]. 临床检验杂志, 2019, 37 (1) : 48-50.    QIN Huihong, WANG Chun, PAN Fen, et al. Drug resistance and β - lactamase genotyping of Haemophilus influenzae isolated from children[J]. Chin J Clin Lab Sci, 2019, 37 (1) : 48-50.
[10] BOZDOGAN B, TRISTRAM S, APPELBAUM P C. Combination of altered PBPs and expression of cloned extended-spectrum beta-lactamases confers cefotaxime resistance in Haemophilus influenzae[J]. J Antimicrob Chemother, 2006, 57(4) :747-749.
[11] 董叶青, 董春富, 俞增仙, 等. 金华武义社区耐氨苄 西林流感嗜血杆菌的流行现状及耐药性研究[J]. 实 用预防医学, 2019, 26 (8) : 1012-1015.    DONG Yeqing, DONG Chunfu, YU Zengxian, et al. Prevalence and drug resistance of ampicillin resistant Haemophilus influenzae in Wuyi community Jinhua[J]. Pract Prev Med, 2019, 26 (8) : 1012-1015.
[12] CHERKAOUI A, GA?A N, BAUD D, et al. Molecular characterization of fluoroquinolones, macrolides, and imipenem resistance in Haemophilus influenzae: analysis of the mutations in QRDRs and assessment of the extent of the AcrAB-TolC-mediated resistance[J]. Eur J Clin Microbiol Infect Dis. 2018, 37(11) : 2201- 2210.
[13] SIERRA Y, TUBAU F, GONZ?LEZ-D?AZ A, et al. Assessment of trimethoprim-sulfamethoxazole susceptibility testing methods for fastidious Haemophilus spp[J]. Clin Microbiol Infect. 2019, 4 (1): 423-428.
[14] MOHD-ZAIN Z, KAMSANI N H, AHMAD, N. Molecular insights of co-trimoxazole resistance genes in Haemophilus influenzae isolated in Malaysia[J]. Trop Biomed. 2013, 30 (4) : 584-590.
[15] HEGSTAD K, MYLVAGANAM H, JANICE J, et al. Role of horizontal gene transfer in the development of multidrug resistance in Haemophilus influenzae[J]. mSphere.2020, 5(1) :e00969-19.
[16] GONZ?LEZ-D?AZ A, TUBAU F, PINTO M, et al. Identification of polysaccharide capsules among extensively drug-resistant genitourinary Haemophilus parainfluenzae isolates[J]. Sci Rep, 2019, 9 (1) : 4481- 4482.

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备注/Memo

备注/Memo:
收稿日期:2020-02-24 修回日期:2020-03-12作者简介:赵智凝(1975 - ),女,博士,主治医师,研究方向:临床微生物检验及耐药机制研究,E-mail:shirley_zzn@sina.com
更新日期/Last Update: 2020-07-20