2006-2011年浙江省杭州市萧山区流感嗜血杆菌耐药性监测

目的 调查了解流感嗜血杆菌的临床分布及耐药情况,为临床用药提供依据。 方法 对2006年1月至2011年12月浙江萧山医院临床分离的流感嗜血杆菌,用ATB嗜血杆菌药敏板条测定抗菌药物的敏感性, 用头孢硝噻吩纸片法测定-内酰胺酶,所有数据用WHONET 5.6软件进行回顾性分析。 结果 共检出流感嗜血杆菌375株,对复方新诺明、氨苄西林耐药分别为248株(66.1%)和127株(33.8%),对氯霉素、头孢克洛和四环素耐药分别为38株(10.2%)、52株(13.8%)和55株(14.7%);其他几种常用药物阿莫西林/克拉维酸、头孢呋辛、头孢噻肟、利福平和氧氟沙星对流感嗜血杆菌保持较好的抗菌活性(耐药率5.0%);-内酰胺酶阳性菌株对多种药物的耐药率显著高于阴性菌株(P0.01)。 结论 复方新诺明耐药率高而不宜用于流感嗜血杆菌感染的治疗, 氨苄西林应慎重用于经验治疗;流感嗜血杆菌对氨苄西林耐药率呈下降趋势,对二代头孢菌素耐药率呈上升趋势,临床应根据药敏结果合理使用抗菌药物。

Surveillance of drug resistance of Haemophilus influenzae in Hangzhou,Zhejiang,2006-2011

Objective To understand the clinical distribution and drug resistance of Haemophilus influenzae in Xiaoshan district in Hangzhou and provide evidence for clinical antibiotic use.Methods The drug susceptibility of H.influenzae strains isolated in Zhejiang Xisoahn hospital from January 2006 to December 2011was tested by using ATB HAEMO strip,β-lactamases was detected with Nitrocefin discs test,and the results were analyzed retrospectively by using WHONET 5.6 software.Results A total of 375 H.influenzae isolates were tested,the resistance rate was 66.1% to trimethoprim-sulfamethoxazole(TMP/SMZ),33.8% to ampicillin,10.2% to chloramphenicol,13.8% to cefaclor and 14.7% to tetracycline.Amoxicillin/clavulanic acid,cefuroxime,cefotaxime,rifampicin and ofloxac in had good antibacterial activity on H.influenzae(the resistance rate ≤5.0%).The resistance rate to multi drugs of β-lactamase positive strains was significantly higher than that of negative strains(P<0.01).Conclusion TMP/SMZ is not suitable for the treatment of H.influenzae infection due to the high resistance rate.Ampicillin should be used with caution in empiric treatment.The resistance rate of H.influenzae to ampicillin is in decline,while the resistance rate to 2nd generation cephalosporin is in increase,it is important to use antibiotics rationally according to the drug susceptibility test results.