摘要
目的调查分析医院获得性副流感嗜血杆菌呼吸道感染的临床特点和对抗菌药物的耐药情况。方法对2002年8月至2005年1月温州医学院附属第一医院住院的116例医院获得性副流感嗜血杆菌呼吸道感染的临床资料进行统计分析,对送检的痰或咽拭子标本用嗜血杆菌专用巧克力培养基(HAE)进行分离培养,VITEK-60微生物自动分析系统进行鉴定以及药敏试验,用Nitrocefin纸片法测定被试菌的β-内酰胺酶。结果116例患者的原发疾病以恶性肿瘤最为常见,其次为恶性血液病和脑血管意外;相关危险因素主要有广谱抗菌药物的应用、放化疗和激素的使用及各类侵袭性操作;临床表现:发热84.5%,咳嗽、咳痰82.8%;药敏试验显示检测株对头孢呋辛、阿莫西林/克拉维酸和利福平的耐药率较低,分别为6.9%、8.6%和9.5%,对氨苄西林、氧氟沙星和复方新诺明的耐药率较高,分别为57.8%、54.3%和86.2%;产β-内酰胺酶的共34株,产酶率为29.3%。结论副流感嗜血杆菌为该地区医院获得性呼吸道感染的主要致病菌,多发生在有各种基础疾病、免疫功能低下者,该菌产酶率较高,抗菌药物可选用头孢呋辛、阿莫西林/克拉维酸、利福平等药物进行治疗。
Objective To analyse the clinical characteristics of hospital acquired respiratory infection caused by Haemophilus parainfluenzae and to investigate the antibiotic resistance of Haemophilus parainfluenzae strains. Methods Retrospective analysis of the clinical data of 116 cases with hospital acquired respiratory tract infection by Haemophilus parainfluenzae during the period from Aug. 2002 to Jan. 2005 had been done. Used VITEK-60 microorganism autoanalysis system to appraise bacteria and its resistance against various antibiotics was carried out. Nirtocefin test was used to detect β-lactamase. Results 100% of the cases had underlying disease,most of which were carcinoma and malignant blood system diseases,inappropriate use of broad spectrum antibiotics,chcmotherapy,radiotherapy,corticosteroids and various invasive treatments used were risk factors. Clinical manifestations included fever （84.5%）, cough and expectoration （82.8%）. The drug sensitivity tests in vitro showed that all strains had lower resistance rate against cefuroxime, amoxicillin/clavulanic acid and rifampicine. And these strains had higher resistance rate against ampicillin, sulfamethoxazole, ofloxacin. There were 34 （29.3 %） strains of Haemophilus parainfluenzae producing β-lactamase. Conclusions The hospital acquired respiratory tract infection by Haemophilus parainfluenzae was developed in patients with various underlying diseases and various risk factors. Antibiotics such as cefuroxime,amoxicillin/clavulanic acid rifampicine could be chosen for the treatment of respiratory tract infection caused by Haemophilus parainfluenzae .
出处
《中国微生态学杂志》
CAS
CSCD
2006年第4期312-314,共3页
Chinese Journal of Microecology
关键词
副流感嗜血杆菌
呼吸道感染
药物敏感试验
Haemophilus parainfluenzae
Respiratory tract infection
Drug sensitivity tests
