摘要
目的分析新乡医学院第一附属医院2011~2015年流感嗜血杆菌的分布特征和耐药性变迁,为疾病防治提供流行病学诊断依据。方法对2011~2015年送检的各种临床标本进行细菌培养、菌种鉴定、β-内酰胺酶检测、血清学分型及药物敏感性试验,并用WHONET 5.5软件进行药物敏感性统计分析。结果 2011~2015年新乡医学院第一附属医院共分离出流感嗜血杆菌849株,其中在≤1岁和≥50岁2个年龄段分离率最高,分别占49.6%、17.8%;主要分布在痰液标本中,其次是血液、脑脊液、咽拭子标本;血清型以不定型流感嗜血杆菌型为主,占85.4%。流感嗜血杆菌对氨苄西林、复方新诺明、四环素、利福平、氯霉素的耐药率较高且处于上升趋势,2011~2015年分别为38.5%~78.7%、41.7%~88.8%、57.7%~83.9%、61.4%~72.2%、20.0%~51.5%;对左氧氟沙星、环丙沙星、莫西沙星、亚胺培南、美洛配能、哌拉西林/他唑巴坦的敏感性较高,对头孢类抗生素的敏感性有所降低。结论流感嗜血杆菌主要来自的临床科室是小儿内科,痰液标本分离出的流感嗜血杆菌最多;应注意本地区体外抗菌药物的耐药变迁,依据药物敏感性试验报告合理用药,加强耐药监控;左氧氟沙星、环丙沙星、莫西沙星可考虑为首选药物。
Objective To analyze the distribution characteristics and drug resistance change of Haemophilus influenzae in the First Affiliated Hospital of Xinxiang Medical University during 2011 -2015, and provide the epidemiological evidence for the prevention and treatment of the disease. Methods Bacterial culture, strain identification, beta lactamase detection, serum typing and drug sensitivity test were carried out in all kinds of clinical specimens which were submitted during 2011 -2015; and drug sensitivity analysis was carried out with WHONET 5.5 software. Results A total of 849 strains of Haemophilus influ- enzae were isolated from 2011 to 2015. The isolation rate of Haemophilus influenzae in ≤ 1 year old（49.6% ） and t〉 50 years old （ 17.8% ）was highest. The Haemophilus influenzae was mainly distributed in sputum specimens, followed by blood, cerebro- spinal fluid and throat swab specimens. The main serum serotype was nontypeable Haemophilus influenzae （85.4%）. The drug resistant rate of Haemophilus influenzae to ampieillin, sulfamethoxazole, tetracycine, rifampin, chloramphenicol was 38.5% - 78.7% ,41.7% - 88.8% ,57.7% - 83.9% ,61.4% - 72.2% ,20.0% - 51.5% respectively from 2011 - 2015 ;the drug re- sistant rate was higher and in an increasing tendency. On the contrary, the drug resistant rate of Haemophilus influenzae to levo- floxacin, eiprofloxacin, moxifloxacin, imipenem, meropenem, piperaeillion tazobaetam was lower. The susceptibility of Haemophi- lus influenzae to cephalosporin was decreased. Conclusions Haemophilus influenzae is mainly isolated from the pediatric de- partment and respiratory tract specimens. We should pay attention to the drug resistance change in this region, and enhance the monitoring of drug resistance. The rational drug is used according to the drug resistant report. Levofloxacin, ciprofloxacin, moxi- floxacin can be considered as the preferred drug.
出处
《新乡医学院学报》
CAS
2017年第10期927-931,共5页
Journal of Xinxiang Medical University
关键词
流感嗜血杆菌
分布特征
耐药性变迁
Haemophilus influenzae
distribution characteristics
drug resistance change
