摘要
目的分析2009-2013年呼吸道感染患者流感嗜血杆菌的检出率、β-内酰胺酶的产生率及对常用抗生素的药物敏感情况。方法镜检合格的急性上呼吸道感染痰液标本,分别划线接种于4块不同平板进行细菌分离培养及鉴定,对分离出的流感嗜血杆菌进行β-内酰胺酶检测,同时进行API稀释法和K-B纸片法药物敏感性试验,结果依据CLSI 2009年版进行判断。结果 2009-2013年分离出的213株流感嗜血杆菌对厄他培南、左氧氟沙星、氯霉素和阿奇霉素均完全敏感,对阿莫西林/棒酸和头孢呋辛敏感率也极高,对氨苄西林和复方磺胺甲恶唑的敏感率较低且逐年下降。成人复方磺胺甲噁唑敏感率低于儿童（P〈0.05）,门诊患者氨苄西林敏感率高于住院患者（P〈0.05）。β-内酰胺酶的产生率为38.5%～51.4%,成人儿童差异无统计学意义（P〉0.05）,而门诊患者产酶率低于住院患者（P〈0.05）。结论流感嗜血杆菌β-内酰胺酶产生率较高,对半合成青霉素耐药率高,对碳青霉烯类抗生素、喹诺酮类抗生素、头孢菌素及β-内酰胺酶抑制剂仍敏感。成人与儿童及门诊与住院患者药物敏感性均有差异。应及时掌握该菌的耐药动态,根据不同年龄及来源患者合理使用抗生素,延缓耐药菌株的产生。
Objective To analyze the detection rate of influenza haemophilus, production rate of β-lactamace and antibiotic susceptibility of respiratory tract infected patients from 2009 to 2013. Methods Qualified sputum specimens of respiratory tract infected patients were inoculated into 4 different disks to isolate and cultivate bacteria. The β-lactamace were detected on the specimens and drug sensitivity tests were done with API dilution method and Kirby-Bauer method, and the results were determined by CLSI 2009. Results The 213 influenza haemophilus were highly sensitive to ertapenem, levofloxaein, chloramphenicol, azithromycin, and highly sensitive to ampicillin/clavulanate and cefaclor, but the sensitive rates were lower to ampicillin and SMZ-TMP, which decreased year by year. The sensitive rate of adults to SMZ-TMP was lower than that of children （P〈0.05）, and outpatients to ampieillin was lower than that of inpatients. The positive rate of β-lactamaee enzyme was 38.5%-51.4%, and there was no difference between adults and children, but the rate of outpatients was lower than that of inpatients. Conclusion Theβ -lactamaee productive rate of influenza haemophilus is very high. The resistant rate to semisynthetic penicillins is high, but the bacteria is still susceptible to earbapenem antibiotics, quinolones, eephalosporins and β-lactamaee inhibitor. The antibiotic susceptibilities are different between adults and children, and between outpatients and inpatients. In order to use antibiotics reasonably and postpone the drug resistance, it is necessary to control the development of the drug resistant of influenza haemophilus and to use the antibiotic reasonably within different people to postpone the generation of drug resistant strains.
出处
《现代预防医学》
CAS
北大核心
2015年第11期2049-2053,共5页
Modern Preventive Medicine
基金
山东省科学技术发展计划(2012GNC11027)
作者简介
孙淑红（1978-），女，硕士，主管技师，研究方向：细菌耐药及院内感染监测
