阿奇霉素非敏感嗜血杆菌的分离及其药敏试验观察

目的 了解2008～2011年阿奇霉素非敏感嗜血杆菌的分离情况及药敏试验特点,为临床治疗提供依据.方法 统计分析2008～2011年本院临床送检呼吸道标本阿奇霉素非敏感嗜血杆菌分离情况,分析其对常用抗菌药物的药敏试验结果,并与阿奇霉素敏感菌株进行对比观察.结果 22 986份呼吸道标本,分离嗜血杆菌1 900株,其中阿奇霉素非敏感菌株共计389株,分离率为21.48%,4年间呈逐年上升趋势;阿奇霉素非敏感嗜血杆菌菌株构成以副流感嗜血杆菌为主,占79.18%,而流感嗜血杆菌只占20.82%.阿奇霉素非敏感流感嗜血杆菌对阿莫西林/克拉维酸、氨苄西林/舒巴坦、头孢呋辛3种抗菌药物的耐药率高于副流感嗜血杆菌,且两种嗜血杆菌对头孢曲松、头孢泊肟、氨曲南、美罗培南和左氧氟沙星均表现敏感性降低.2008～2011年间阿奇霉素非敏感嗜血杆菌对氨苄西林耐药率逐年增高;与敏感菌株相比,流感嗜血杆菌非敏感株对氨苄西林、氨苄西林/舒巴坦、头孢曲松、氨曲南、左氧氟沙星耐药率或非敏感率显著增高;而对于副流感嗜血杆菌,非敏感菌株对试验药物耐药率或非敏感率均显著增高.结论 嗜血杆菌阿奇霉素非敏感菌株逐年增加,其对常用抗菌药物的耐药率或非敏感率均高于阿奇霉素敏感株.

Analysis of antibiotics susceptibility and isolation of Haemophilus unsusceptible to azithromycin

Objective To evaluate the status and antimicrobial susceptibility of azithromycin unsusceptible haemophilus strains isolated from respiratory tract infection from 2008 to 2011,to provide a basis for clinical treatment.Methods Azithromycin unsusceptible haemophilus strains isolated from respiratory tract specimens from 2008 to 2011 was analyzed by statistic methods,and their susceptibility to commonly used antibiotics was analyzed and compared with azithromycin susceptible strains.Results 1 900 haemophilus isolated from 22 986 respiratory specimens,among which 389 strains were azithromycin unsusceptible haemophilus,with isolation rate of 21.48%,and isolation rate had the trend to ascend during the four years.In 389 azithromycin unsusceptible haemophilus,Haemophilus parahaemolyticus accounted for 308(79.18%),Haemophilus influenzae only accounted for 81(20.82%).The resistant rate of azithromycin unsusceptible Haemophilus influenzae to amoxicillin/Clavulanic acid,ampicillin/sulbactam,cefuroxime was higher than that of azithromycin unsusceptible Haemophilu parahaemolyticus,and both of them were with reduced susceptibility to ceftriaxone,cefpodoxime,aztreonam,meropenem,levofloxacin.The resistant rate of azithromycin unsusceptible haemophilus to ampicillin increased year by year from 2008 to 2011.Compared with susceptible strains,azithromycin unsusceptible Haemophilus influenzae had a significantly higher resistant rate or unsusceptible rate to ampicillin,ampicillin/sulbactam,ceftriaxone,aztreonam,levofloxacin.But for Haemophilus parahaemolyticus,azithromycin unsusceptible strains had a notable higher resistant and unsusceptible rate to the test antimicrobials.Conclusion Azithromycin unsusceptible haemophilus might increase year by year,with high resistant and unsusceptible rate to commonly used antibiotics.