肺炎链球菌和流感嗜血杆菌分布及耐药性分析

目的：了解临床分离流感嗜血杆菌和肺炎链球菌的分布及耐药情况，为临床合理使用抗菌药物、预防和控制感染提供依据。方法：收集医院2005-2012年各类临床标本分离流感嗜血杆菌92株、肺炎链球菌83株，均经全自动细菌鉴定仪鉴定，用K—B法检测流感嗜血杆菌对常用的15种抗生素及肺炎链球菌对常见的13种抗生素的敏感性，并用头孢硝噻吩纸片法检测流感嗜血杆菌产β-内酰胺酶情况。结果：流感嗜血杆菌和肺炎链球菌主要来源于呼吸道标本，不同季节流感嗜血杆菌的感染率不同，冬春两季为高发季节，肺炎链球菌感染患者的年龄呈双峰分布，以年龄〈5岁和〉50岁的感染者最多。流感嗜血杆菌对氨苄西林、复方新诺明和头孢呋辛的耐药率较高，产β-内酰胺酶检出率为64．17％。肺炎链球菌对红霉素、氯霉素、四环素、克林霉素耐药性非常严重，其中47株（56．63％）为青霉素不敏感肺炎链球菌（PNSP）。结论：流感嗜血杆菌和肺炎链球菌耐药情况较为严重，对流感嗜血杆菌和肺炎链球菌的耐药性进行严密监测具有重要意义。

Distribution and drug resistance analysis of Streptococcus pneumonia and Haemophilus influenzae

Objective ： To investigate the characteristics of distribution and drug resistance of Haemophilus influenzae and Streptococcus pneumoniae, provide the basis of using antimicrobial drugs for clinical. Methods ： 92 clinical isolates of Haemophilus influenzae and 83 isolates of Streptococcus pneumoniae were collected during 2003 to 2012, and then identified by Vitek-2 system. K-B disk method was used to test antimicrobial susceptibility. β -lactamase was detected with nitrocefin disk testing.Results ： 92 Haemophilus influenzae and 83 Streptococcus pneumoniae of clinical isolates mainly from respiratory, The higher infectious season of Haemophilus influenza was winter and spring. The age of the Streptococcus pneumoniae infection patient is bimodal distribution, mainly 〈5 years old and 〉50 years old. The resistance rates of Haemophilus influenzae to ampicillin, cotrimoxazole and cefuroxime were high, and 64.17% Haemophilus influenzae produced β -lactamase. The resistance rates of Streptococcus pneumoniae to erythromycin, chloramphenicol, tetracycline, clindamycin were serious, and there were 47 （56.63%） isolates of Streptococcus pneumoniae were penicillin non-susceptible （PNSP）. Conclusions ： The resistance of Haemophilus influenzae and Streptococcus pneumoniae were serious. Monitoring the resistance of Haemophilus influenzae and Streptococcus pneumoniae will help to reduce the generation of resistant strains.