CAJ | 학술논문

目的了解儿童来源的流感嗜血杆菌(Hi)分离株对常用抗菌药物的敏感性和体外耐药模式,为临床合理用药提供参考.方法对杭州市2006年12月至2007年6月经V因子、X因子和V+X因子试验鉴定的152株Hi用头孢硝噻酚法检测β-内酰胺酶,用纸片扩散法检测其对12种抗菌药物的敏感性,并用E-test法检测氨苄西林(AMP)的最低抑菌浓度(MIC).结果 152株菌株中,对AMP的敏感率为74.3%,耐药率为22.4%,检测AMP对141株菌株的MIC,MIC50为0.250 μg/mL,MIC90为12 μg/mL.34株β-内酰胺酶阳性,产酶率为22.4%,β-内酰胺酶阴性的耐AMP株共2株.菌株对头孢哌酮-舒巴坦(CFS)、亚胺培南(IMP)、阿莫西林-克拉维酸(AMC)、头孢噻肟(CXT)、头孢曲松(CRO)、利福平(RIF)和头孢克洛(CEC)的敏感率为94.1%～100.0%,对复方磺胺甲口恶唑(SXT)的耐药率最高,达65.8%,对克拉霉素(CLR)、氯霉素(CHL)和四环素(TET)的耐药率分别为7.9%、14.5%和20.4%,仅34株菌株(22.4%)对12种抗菌药物均敏感.结论杭州地区儿童来源的Hi耐药率呈上升趋势,临床应根据药敏结果合理使用抗菌药物.
목적 료해인동래원적류감기혈간균(Hi)분리주대상용항균약물적민감성화체외내약모식,위림상합리용약제공삼고.방법 대항주시2006년12월지2007년6월경V인자、X인자화V+X인자시험감정적152주Hi용두포초새분법검측β-내선알매,용지편확산법검측기대12충항균약물적민감성,병용E-test법검측안변서림(AMP)적최저억균농도(MIC).결과 152주균주중,대AMP적민감솔위74.3%,내약솔위22.4%,검측AMP대141주균주적MIC,MIC50위0.250 μg/mL,MIC90위12 μg/mL.34주β-내선알매양성,산매솔위22.4%,β-내선알매음성적내AMP주공2주.균주대두포고동-서파탄(CFS)、아알배남(IMP)、아막서림-극랍유산(AMC)、두포새우(CXT)、두포곡송(CRO)、리복평(RIF)화두포극락(CEC)적민감솔위94.1%～100.0%,대복방광알갑구악서(SXT)적내약솔최고,체65.8%,대극랍매소(CLR)、록매소(CHL)화사배소(TET)적내약솔분별위7.9%、14.5%화20.4%,부34주균주(22.4%)대12충항균약물균민감.결론 항주지구인동래원적Hi내약솔정상승추세,림상응근거약민결과합리사용항균약물.
Objective To investigate the antibiotics resistance patterns of Haemophilus influenzae (Hi) isolated from children with respiratory tract infection in Hangzhou and offer the reference of clinical rational drug use. Methods 152 isolates were collected from December 2006 to June 2007 and were identified as Hi with V factor, X factor and V+X factor test. Nitrocefin test was used to detect β-lactamase. The sensitivities of 12 antibiotics against 152 strains were determined in vitro by Kirby-Bauer diffusion methods and the minimal inhibitory concentration(MIC) of ampicillin (AMP) was determined by E-test method. Results Of all 152 isolates,the susceptibility to AMP was 74.3% while the resistance rate was 22.4%. The MIC ranges of AMP in 141 isolates were detected. MIC50 was 0.250 μg/mL and MIC90 was 12 μg/mL. 34 isolates (22.4%) were β-lactamase positive strains,and 2 β-lactamase negative strains resistant to AMP were found. The sensitive rates to cefoperazone-sulbactam (CFS), imipenem (IMP), amoxicillin-clavulanic acid (AMC), cefotaxime (CXT), ceftriaxone (CRO), rifampin (RIF) and cefaclor (CEC) were from 94.1% to 100.0%. 100 strains (65.8%) were resistant to trimethoprim-sulfamethoxazole (SXT), followed by those of clarithromycin (CLR),chloramphenicol (CHL) and tetracycline (TET) were 7.9%,14.5% and 20.4%.Only 34 strains (22.4%) were sensitive to all 12 kinds of antibiotics. Conclusions The resistance rate of Hi isolated from children in Hangzhou is in an upward trend,so antibiotics should be used rationally and be based on the drug sensitivity results in clinical therapy.