| 摘要: |
| 目的：了解本地区儿童呼吸道感染流感嗜血杆菌的分布及耐药情况，为抗菌药物的使用提供参考。方法：收集2017年3月至2019年2月我院儿科收治的社区获得性肺炎患儿811例，对其痰标本进行培养，对流感嗜血杆菌感染的患儿年龄、时间分布及产β-内酰胺酶、耐药表型、耐药性进行总结分析。结果：811例患儿共检出流感嗜血杆菌102株，检出率12.58%，>1个月~1岁组检出率最高，达17.62%，高于其余各年龄组患儿检出率（P<0.01）。春季是本地区流感嗜血杆菌感染的高发季节，检出率19.41%，而秋季最低，检出率5.77%，差异有统计学意义（P<0.05）。β-内酰胺酶阴性氨苄西林耐药菌株及β-内酰胺酶阴性阿莫西林/克拉维酸耐药菌株的检出逐年率增加，分别从8.86%增长到43.48%、5.06%增长到21.74%，差异有统计学意义（P均<0.05）；流感嗜血杆菌对氨苄西林、阿奇霉素、头孢克洛、头孢呋辛、氨苄西林/舒巴坦、阿莫西林/克拉维酸有不同程度的耐药，其中对阿莫西林/克拉维酸的耐药性逐年升高，由24.05%升至47.83%，两年间耐药性比较差异有统计学意义（P<0.05）。结论：儿童呼吸道感染流感嗜血杆菌的检出率有年龄、季节差异，产酶率较高，对不同抗菌药物有不同程度的耐药性。β-内酰胺酶阴性氨苄西林耐药菌株及β-内酰胺酶阴性阿莫西林/克拉维酸耐药菌株的检出增加值得临床关注。 |
| 关键词: 儿童 呼吸道感染 流感嗜血杆菌 耐药性 |
| DOI：doi:10.13407/ j.cnki.jpp.1672.108X.2021.09.013 |
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| 基金项目: |
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| Distribution and Drug Resistance of Haemophilus Influenzae in Children with Respiratory Tract Infection |
| Li Ran, Liu Min, Pan Jing |
| (Jinan City People’s Hospital Affiliated to Shandong First Medical University, Shandong Jinan 271199, China) |
| Abstract: |
| Objective: To probe into the distribution and drug resistance of Haemophilus influenzae in children with respiratory tract infection in this region, so as to provide reference for rational application of antibiotics. Methods: A total of 811 children with community-acquired pneumonia admitted to pediatrics of our hospital from Mar. 2017 to Feb. 2019 were collected. The sputum samples were cultured, and the age, seasonal distribution, β-lactamase production, drug resistance phenotype and drug resistance of children infected by H. influenzae were summarized and analyzed. Results: A total of 102 strains of H. influenzae were detected in 811 children, and the detection rate was 12.58%. The highest detection rate was 17.62% in the >1 month to 1 year old group, higher than the detection rates of other age groups (P<0.01). Spring was the most frequent season for H. influenzae infection in this region, with the detection rate of 19.41%, while autumn was the lowest, with the detection rate of 5.77%, the difference was statistically significant (P<0.05). The detection rate of β-lactamase negative ampicillin resistant strains and β-lactamase negative amoxicillin/clavulanate resistant strains respectively increased from 8.86% to 43.48% and from 5.06% to 21.74%, with statistically significant difference (P<0.05). H. influenzae had various degrees of resistance to ampicillin, azithromycin, cefaclor, cefuroxime, ampicillin/sulbactam, and amoxicillin/clavulanic acid, of which the resistance to amoxicillin/clavulanic acid increased year by year, from 24.05% to 47.83%, and the difference of resistance was statistically significant (P<0.05). Conclusion: H. influenzae detection rate in children with respiratory tract infection varies in different age and season. H. influenzae has generally high β-lactamase production and various resistant degrees among different antibiotics. The increased detection rate of β-lactamase negative ampicilin and β-lactamase negative amoxicillin potassium clavulanate resistant strain is worthy of clinical attention. |
| Key words: children respiratory tract infection Haemophilus influenzae drug resistance |
