摘要
目的了解首都医科大学附属北京儿童医院临床分离流感嗜血杆菌相关临床资料及对抗菌药物的耐药率,为临床合理使用抗菌药物提供依据。方法收集2015年1月1日—2019年12月31日该院儿童患者临床分离的3 026株非重复流感嗜血杆菌,采用纸片扩散法进行药敏试验,应用WHONET 5.6软件对药敏结果进行分析。结果流感嗜血杆菌感染多见于婴幼儿,以呼吸道感染为主,多见于冬春季。分离的流感嗜血杆菌中1 760株(58.2%)产β内酰胺酶,92株(3.0%)为β内酰胺酶阴性氨苄西林耐药菌株。流感嗜血杆菌对甲氧苄啶-磺胺甲噁唑的耐药率最高,为66.1%,其次为氨苄西林 (61.2%)、头孢克洛 (43.8%)、头孢呋辛(35.5%)和阿莫西林-克拉维酸(19.6%),对阿奇霉素和头孢唑肟的不敏感率分别为35.8%和5.1%,未检出对头孢曲松和美罗培南不敏感菌株。结论儿童患者分离的流感嗜血杆菌β内酰胺酶阳性率很高,是对氨苄西林耐药的主要机制,氨苄西林已不能作为临床治疗流感嗜血杆菌感染的一线用药。流感嗜血杆菌对抗菌药物的耐药率逐年升高,临床应根据药敏结果合理选用抗菌药物,减缓耐药菌株的产生。
Objective To investigate the distribution and antibiotic resistance profile of the Haemophilus influenzae strains isolated from Beijing Children’s Hospital,Capital Medical University,and to provide laboratory data for rational use of antimicrobial reagents in clinical practice.Methods A total of 3026 H.influenzae strains were collected from Beijing Children’s Hospital from 2015 to 2019.Antimicrobial susceptibility was determined by disk diffusion method.WHONET 5.6 software was used for data analysis.Results H.influenzae strains were mostly isolated from infants and young children,from respiratory tract,and primarily in winter and spring.About 58.2%(1760/3026)of the strains producedβ-lactamase,and 3.0%(92/3026)wereβ-lactamase-nonproducing ampicillin-resistant strains.The H.influenzae strains showed the highest resistance rate to trimethoprim-sulfamethoxazole(66.1%),followed by ampicillin(61.2%),cefaclor(43.8%),cefuroxime(35.5%),and amoxicillin-clavulanic acid(19.6%).About 35.8%and 5.1%of the strains were not susceptible to azithromycin and cefixime,respectively.All of the strains were susceptible to ceftriaxone and meropenem.Conclusions The high prevalence ofβ-lactamase production in the H.influenzae strains isolated from children is the main mechanism of ampicillin resistance,which makes ampicillin not suitable as the first-line treatment.The antimicrobial resistance rate of H.influenzae is increasing year by year.Therefore,clinicians should choose antibiotics rationally according to the results of antimicrobial susceptibility testing in order to slow down the emergence of drug-resistant strains.
作者
吕志勇
董方
宋文琪
甄景慧
周为
杨溪
Lü Zhiyong;DONG Fang;SONG Wenqi;ZHEN Jinghui;ZHOU Wei;YANG Xi(Department of Clinical Laboratory,Beijing Children’s Hospital,Capital Medical University,National Center for Children’s Health,Beijing 100045,China)
出处
《中国感染与化疗杂志》
CAS
CSCD
北大核心
2021年第4期461-466,共6页
Chinese Journal of Infection and Chemotherapy
关键词
儿童
流感嗜血杆菌
耐药性
children
Haemophilus influenzae
antibiotic resistance
