摘要
目的：研究住院患儿流感嗜血杆菌（Hi）感染的基本临床特征及耐药动态。方法回顾性断面调查2011年6月至2013年5月间成都市第三人民医院0~17岁住院患儿痰液和咽拭子Hi分离情况。结果共分离出Hi 117株，111例患儿纳入调查，其中102例为呼吸系统感染（91.9%），其他疾病9例（8.1%）。支气管肺炎及肺炎患儿Hi检出率为50.8%（30/59），急性喉气管支气管炎50.0%（2/4），毛细支气管炎34.6%（9/26），急性支气管炎24.2%（32/132），喘息性支气管炎17.9%（5/28），疱疹性咽峡炎19.0%（4/21），急性上呼吸道感染11.8%（9/76），急性扁桃体炎8.2%（7/85），新生儿肺炎5.6%（3/54）。两个调查年度间阿莫西林克拉维酸（15%vs 23%，P=0.010）和氯霉素（25%vs 8%，P=0.015）耐药率差异有统计学意义。β-内酰胺酶阴性氨苄西林耐药菌株（BLNAR）和β-内酰胺酶阳性阿莫西林克拉维酸耐药菌株（BLPACR）两年间均有增长，分别从12%增加到21%，13%增加到19%，但差异未达统计学意义（P〉0.05）。结论 Hi在0~17岁儿童呼吸道感染中扮演着重要角色；BLNAR和BLPACR呈增长趋势将使临床面临更加严峻的抗菌素选择压力。
Objective To investigate the basic clinical characteristics and drug resistance of Haemophilus inlfuenzae （Hi） infection in hospitalized children in the past two years. Methods A retrospective cross-sectional study was conducted to analyze Hi strains isolated from the sputum and pharyngeal swabs of children aged 0-17 years who were hospitalized in the Third People＆#39;s Hospital of Chengdu between June 2011 and May 2013. Results A total of 117 strains were isolated from 111 hospitalized children. There were 102 cases （91.9%） of respiratory infection and 9 cases （8.1%） of other diseases. The positive rates of Hi in children with bronchopneumonia or pneumonia （50.8%, 30/59） and in children with acute laryngotracheobronchitis （50.0%, 2/4） were relatively high, followed by in children with capillary bronchitis （34.6%, 9/26）, in children with acute bronchitis （24.2%, 32/132）, in children with herpangina （19.0%, 4/21）, in children with asthmatoid bronchitis （17.9%, 5/28）, in children with acute upper respiratory tract infection （11.8%, 9/76）, in children with acute tonsillitis （8.2%, 7/85）, and in children with neonatal pneumonia （5.6%, 3/54）. There were signiifcant differences in the rates of resistance to amoxicillin-clavulanate （15%vs 23%;P=0.010） and chloramphenicol （25%vs 8%;P=0.015） between the two survey years. The frequencice ofβ-lactamase-nonproducing-ampicillin-resistant （BLNAR） strains andβ-lactamase-producing-amoxicilli/clavulanate-resistant （BLPACR） strains increased from 12%to 21%and from 13%to 19%respectively during the two survey years （P〉0.05）. Conclusions Hi plays an important role in the respiratory tract infection of children aged 0-17 years. The increasing trend of BLNAR and BLPACR rates makes it harder for antibiotic selection in clinical practice.
出处
《中国当代儿科杂志》
CAS
CSCD
北大核心
2015年第6期596-601,共6页
Chinese Journal of Contemporary Pediatrics
基金
四川省科技厅应用基础研究项目(2013JY0121)
