肿瘤患者呼吸道感染嗜血杆菌的临床分布与耐药性分析

  目的   分析肿瘤患者呼吸道感染嗜血杆菌的临床分布与耐药状况，为临床规范应用抗生素提供依据。   方法   收集2010年2月至2010年11月天津医科大学附属肿瘤医院住院的肿瘤患者早晨痰液样本，采用含有Ⅹ、Ⅴ因子的巧克力琼脂平板分离培养嗜血杆菌，应用Vitek2-Compact全自动细菌鉴定分析仪鉴定菌种，药敏试验采用微量肉汤稀释法进行。采用头孢硝噻吩纸片法检测β-内酰胺酶。   结果   从7 333份呼吸道标本中检出316株嗜血杆菌，其中流感嗜血杆菌95株，副流感嗜血杆菌221株。流感嗜血杆菌对头孢噻肟、左氧氟沙星、美罗培南均敏感，对复方新诺明、氨苄西林的耐药率分别为26.3%、15.8%。对头孢类及β-内酰胺/β-内酰胺酶抑制剂、大环内酯类、氯霉素类抗生素较敏感。副流感嗜血杆菌与流感嗜血杆菌的药敏谱相似。   结论   大多数抗菌药物对肿瘤患者呼吸道感染的嗜血杆菌仍保持良好的抗菌活性，临床应根据药敏结果规范使用抗菌药物。 

Clinical Distribution and Resistance Analysis of Haemophilus Isolated from the Respiratory Tract of Patients with Tumors

  Objective   To analyze the clinical distribution and the resistance status of Haemophilus isolated from the respiratory tract of patients with tumors, and supply envidence for the standard application of antibiotics in clinical practices.   Methods   Chocolate agar plates containing X and V factors were used to isolate and culture Haemophilus. Vitek2-Compact was applied to identify the species. In vitro antibiotic susceptibility experiments were performed by the broth microdilution method. The cephalosporin nitrocefin disk diffusion method was used to detect β-lactamase.   Results   A total of 316 isolates were detected from 7333 respiratory specimens, including 95 isolates of Haemophilus influenzae (Hi) and 221 isolates of Haemophilus parainfluenzae (Hpi). All Hi isolates were sensitive to cefotaxime, levofloxacin, and meropenem. The resistance rates to Compound Sulfamethoxazole and ampicillin were 26.3% and 15.8%, respectively. About 90% or above of the Hi isolates were sensitive to cephalosporins, β-lactamase/β-lactamase inhibitor, macrolides, and chloromycetin. The antimicrobial resistance of Hpi was similar to that of Hi.   Conclusion   The majority of antibiotics maintained good antibacterial activity in cancer patients with respiratory tract infection caused by Haemophilus. The clinical application of antibiotics should be based on the results of in vitro antibiotic susceptibility testing.