2018~2020年大理市某三甲医院嗜血杆菌感染分布及耐药性分析

Distribution and Drug Resistance Analysis of Haemophilus Infections in a Tertiary Care Hospital in Dali from 2018 to 2020

摘要: 目的：分析大理大学第一附属医院流感嗜血杆菌感染分布特点、耐药性及其变化趋势。方法：对大理大学第一附属医院2018年1月初至2020年12月底患者的口痰、咽拭子标本进行分离培养和细菌鉴定、药敏试验和结果判定，对数据进行统计分析。结果：共分离205株流感嗜血杆菌，流感嗜血杆菌195株，副流感嗜血杆菌15株。标本主要来源于痰液(93.16%)、咽拭子(5.79%)；男性(69.47%)比女性(30.53%)患病率更高。流感嗜血杆菌与副流感嗜血杆菌均对氨苄西林的耐药率高于63.74%，对复方磺胺甲噁唑的耐药率高于53.33%，对头孢呋辛耐药率高于26.37%，而对氨曲南、氯霉素、美罗培南、头孢他啶、阿奇霉素的耐药率低(0.00%~33.33%)，尤以美罗培南耐药率最低(0.00%~2.20%)。结论：嗜血杆菌感染好发于低龄儿童、免疫力低下以及患有慢性呼吸系统疾病的人群，嗜血杆菌对药物复方磺胺甲噁唑和氨苄西林耐药性高，但对美罗培南耐药性较低，临床医生应根据药敏结果合理选用抗生素，避免耐药菌株的产生。

Abstract: Objective: To analyze the distribution characteristics, drug resistance and its changing trend of Haemophilus influenzae infection in the First Affiliated Hospital of Dali University. Methods: Oral sputum and pharyngeal swab specimens from patients at the First Affiliated Hospital of Dali University from early January 2018 to the end of December 2020 were isolated and cultured, bacterial identification, drug sensitivity tests and results were determined, and the data were statistically analyzed. Results: A total of 205 strains of Haemophilus influenzae, 195 strains of Haemophilus influenzae and 15 strains of Haemophilus parainfluenzae were isolated. The specimens were mainly from sputum (93.16%) and pharyngeal swabs (5.79%); the prevalence was higher in males (69.47%) than in females (30.53%). Both Haemophilus influenzae and Haemophilus parainfluenzae had resistance rates higher than 63.74% to ampicillin, higher than 53.33% to cotrimoxazole, higher than 26.37% to cefuroxime, and lower than 0.00%~33.33% to amineptine, chloramphenicol, meropenem, ceftazidime, and azithromycin, with meropenem in particular having the lowest resistance rate (0.00%~2.20%). Conclusion: Haemophilus infections are more common in younger children, people with low immunity and chronic respiratory diseases. Haemophilus is highly resistant to the drugs compound sulfamethoxazole and ampicillin, but less resistant to meropenem, clinicians should choose antibiotics reasonably according to the drug sensitivity results to avoid the generation of drug-resistant strains.