成人呼吸道感染副流感嗜血杆菌生物学分型及耐药性

目的了解某院成人呼吸道感染副流感嗜血杆菌的生物型，以及其与产β 内酰胺酶及耐药性的关系。方法收集该院2011年10月-2012年7月临床确诊为呼吸道感染患者（成人）的痰标本1 994份，进行嗜血杆菌分离培养；对分离的副流感嗜血杆菌进行鉴定、生物学分型、β 内酰胺酶试验和药敏试验。结果1 994份痰标本共分离嗜血杆菌102株（5.12%），其中副流感嗜血杆菌68株（66.67%），流感嗜血杆菌20株（19.61%），其他嗜血杆菌14株（13.72%）。副流感嗜血杆菌共检出Ⅰ～Ⅵ 6种生物型，分别为：Ⅰ型42株，Ⅴ型14株，Ⅱ、Ⅵ型各4株，Ⅲ、Ⅳ型各2株；其中54株（79.41%）产β 内酰胺酶。副流感嗜血杆菌对氨苄西林、左氧氟沙星、四环素和复方磺胺甲口恶唑呈现较高的耐药率，分别为83.82%、60.29%、57.35%和70.59%；对头孢噻肟、氨苄西林/舒巴坦、头孢克洛、克拉霉素、利福平的耐药率分别为8.82%、13.24%、5.89%、20.58%和25.00%；尚未检出对亚胺培南、氯霉素耐药的菌株。各生物型副流感嗜血杆菌对抗菌药物的耐药性存在一定差异。结论副流感嗜血杆菌是该院成人呼吸道感染的常见病原菌之一，Ⅰ型和Ⅴ型为主要流行生物型；多数菌株为产β 内酰胺酶株，临床应重视副流感嗜血杆菌生物学及耐药性分型监测，防止耐药菌株流行。

Biotypes and antimicrobial resistance of Haemophilus parainfluenzae isolated from adults with respiratory tract infection

Objective To investigate the biotypes of Haemophilus parainfluenzae（H.parainfluenzae）isolated from adults with respiratory tract infection in a hospital and relationship of H.parainfluenzae with producing ofβ-lactamase and antimicrobial resistance.Methods 1 994 sputum specimens from adult patients with respiratory tract infection from October 2011to July2012 were taken for Haemophilusisolation and culture,the isolated H.parainfluenzae were identified,performed biotyping,β-lactamase detection and antimicrobial susceptibility testing.Results A total of 102 isolates（5.12%）of Haemophilus were isolated,68（66.67%）of which were H.parainfluenzae,20（19.61%）were Haemophilus influenzae,and 14（13.72%）were other types of Haemophilus.Six biotypes（Ⅰ-Ⅵ）were detected among H.parainfluenzae,typeⅠ,Ⅱ,Ⅲ,Ⅳ,Ⅴ,Ⅵ were 42,4,2,2,14,and 4 isolates,respectively.There were 54（79.41%）β-lactamase-producing isolates.H.parainfluenzae had higher resistance to ampicillin（83.82%）,levofloxacin（60.29%）,tetracycline（57.35%）,and sulfamethoxazole/trimethoprim（70.59%）.The resistant rates to cefotaxime,ampicillin/sulbactam,cefaclor,clarithromycin,and rifampicin was8.82%,13.24%,5.89%,20.58% and 25.00%,respectively;There were no strains resistant to imipenem and chloramphenicol.There were some differences in antimicrobial resistance among various biotypes.Conclusion H.parainfluenzaeis a common pathogen in adults with respiratory tract infection in this hospital,the major epidemic biotypes are typeⅠand V,most isolates produceβ-lactamase,detection of biotypes and antimicrobial resistance of H.parainfluenzae should be paid attention.