医学检验与临床
醫學檢驗與臨床
의학검험여림상
Medical Laboratory Science and Clinics
2015年
4期
5-8
,共4页
江秀爱%王荣%张秀云%乔显森
江秀愛%王榮%張秀雲%喬顯森
강수애%왕영%장수운%교현삼
流感嗜血杆菌%耐药基因%β内酰胺酶%生物学分型
流感嗜血桿菌%耐藥基因%β內酰胺酶%生物學分型
류감기혈간균%내약기인%β내선알매%생물학분형
Haemophilus influenzae%Antibiotic resistance gene%beta lactamases%Biotyping
目的：了解本院临床分离流感嗜血杆菌的生物学分型及耐药基因，为临床合理用药提供依据。方法：收集呼吸道感染病人的痰液和咽拭子，用手工法和MicSCAN4全自动细菌鉴定分析仪，HNID鉴定板对分离培养的110株流感嗜血杆菌进行菌种鉴定并进行生物学分型。用纸片琼脂扩散（K-B）法进行药敏试验，采用头孢硝噻吩纸片法进行β内酰胺酶检测，PCR方法进行耐药基因的检测。结果：临床分离110株流感嗜血杆菌，共检出Ⅰ、Ⅱ、Ⅲ、Ⅳ、Ⅴ、Ⅵ、Ⅶ型7种生物型，未检出Ⅷ型，以Ⅱ、Ⅲ型为主，分别是生物Ⅱ型38株（34.5%），生物Ⅲ型46株（41.8%），共有45株检出TEM基因和ROB基因，分别占93.3%、6.7%。冬季感染率最高。流感嗜血杆菌对氨苄西林耐药率为40.9%，β内酰胺酶株产酶率为40.9%。对头孢呋辛、头孢噻肟、氯霉素的敏感率都在90%以上，未检出美罗培南耐药菌株。结论：呼吸道流感嗜血杆菌感染好发于冬季，感染的生物型均以生物Ⅱ型、生物Ⅲ型为主，对氨苄西林和甲氧苄啶-磺胺甲噁唑的耐药率较高，已不宜用于流感嗜血杆菌引起感染的经验治疗。Hi对氨苄西林的耐药主要是产生β内酰胺酶，且主要为TEM-1型。对该菌所致呼吸道感染可选用头孢呋辛、头孢噻肟、美罗培南作为治疗的首选药物。
目的：瞭解本院臨床分離流感嗜血桿菌的生物學分型及耐藥基因，為臨床閤理用藥提供依據。方法：收集呼吸道感染病人的痰液和嚥拭子，用手工法和MicSCAN4全自動細菌鑒定分析儀，HNID鑒定闆對分離培養的110株流感嗜血桿菌進行菌種鑒定併進行生物學分型。用紙片瓊脂擴散（K-B）法進行藥敏試驗，採用頭孢硝噻吩紙片法進行β內酰胺酶檢測，PCR方法進行耐藥基因的檢測。結果：臨床分離110株流感嗜血桿菌，共檢齣Ⅰ、Ⅱ、Ⅲ、Ⅳ、Ⅴ、Ⅵ、Ⅶ型7種生物型，未檢齣Ⅷ型，以Ⅱ、Ⅲ型為主，分彆是生物Ⅱ型38株（34.5%），生物Ⅲ型46株（41.8%），共有45株檢齣TEM基因和ROB基因，分彆佔93.3%、6.7%。鼕季感染率最高。流感嗜血桿菌對氨芐西林耐藥率為40.9%，β內酰胺酶株產酶率為40.9%。對頭孢呋辛、頭孢噻肟、氯黴素的敏感率都在90%以上，未檢齣美囉培南耐藥菌株。結論：呼吸道流感嗜血桿菌感染好髮于鼕季，感染的生物型均以生物Ⅱ型、生物Ⅲ型為主，對氨芐西林和甲氧芐啶-磺胺甲噁唑的耐藥率較高，已不宜用于流感嗜血桿菌引起感染的經驗治療。Hi對氨芐西林的耐藥主要是產生β內酰胺酶，且主要為TEM-1型。對該菌所緻呼吸道感染可選用頭孢呋辛、頭孢噻肟、美囉培南作為治療的首選藥物。
목적：료해본원림상분리류감기혈간균적생물학분형급내약기인，위림상합리용약제공의거。방법：수집호흡도감염병인적담액화인식자，용수공법화MicSCAN4전자동세균감정분석의，HNID감정판대분리배양적110주류감기혈간균진행균충감정병진행생물학분형。용지편경지확산（K-B）법진행약민시험，채용두포초새분지편법진행β내선알매검측，PCR방법진행내약기인적검측。결과：림상분리110주류감기혈간균，공검출Ⅰ、Ⅱ、Ⅲ、Ⅳ、Ⅴ、Ⅵ、Ⅶ형7충생물형，미검출Ⅷ형，이Ⅱ、Ⅲ형위주，분별시생물Ⅱ형38주（34.5%），생물Ⅲ형46주（41.8%），공유45주검출TEM기인화ROB기인，분별점93.3%、6.7%。동계감염솔최고。류감기혈간균대안변서림내약솔위40.9%，β내선알매주산매솔위40.9%。대두포부신、두포새우、록매소적민감솔도재90%이상，미검출미라배남내약균주。결론：호흡도류감기혈간균감염호발우동계，감염적생물형균이생물Ⅱ형、생물Ⅲ형위주，대안변서림화갑양변정-광알갑오서적내약솔교고，이불의용우류감기혈간균인기감염적경험치료。Hi대안변서림적내약주요시산생β내선알매，차주요위TEM-1형。대해균소치호흡도감염가선용두포부신、두포새우、미라배남작위치료적수선약물。
Objective:To investigatethe biotype and resistant gene of clinical isolated haemophilus,so as to guide the rational use of antibiotics in clinic. Methods:He sputum and throat swab were collected from respiratory tract infact patients.strain identification and biotype of 110 cases of haemophilus were conducted using the MicSCAN4 analytic instrument .Antimicrobial susceptibility were tested by Kirby-Bauer method, and Beta lactamases were detected by nitrocefin filter paper method,The resistance gene were detected by polymerase chain reaction(PCR).Results:Seven biotypes (Ⅰ、Ⅱ、Ⅲ、Ⅳ、Ⅴ、Ⅵ、Ⅶ) were detected among 110 cases of clinical isolated haemophilus,The main types were type Ⅱ (38strains,34.5%)and type Ⅲ (46 strains, 41.8%),and typeⅧwas not detected.a total of 45 strains of TEM gene and ROB gene were detected, 93.3%as TEM gene, 6.7%as ROB gene. winter infection rate was the highest.Drug resistance of the strains agains ampicillin was 40.9%, The prevalence of beta lactamase of all strains was 40.9%. The drug resistance rate to cefotaxime,cefuroxime and chloramphenicol was over 90%.,the resistant strain was not detected to meropenem. Conclusions:The respiratory tract infections of Haemophilus influenzae were more prevalent in winter and TrpyⅡand typeⅢwere the most prevalent types.The drug resistance of Haemophilus influenzae to ampicillin and trimethoprim-sulfamethoxazole is increasing ,should not be used as an empirical treatment of Haemophilus infection. suggesting that the cefotaxime , cefuroxime and meropenem could serve as an ideal option for the treatment.
