摘要目的 回顾性分析2016年1月至2017年12月本院儿科住院患者流感嗜血杆菌分布特征,并对常用抗菌药物药敏结果进行分析,为临床合理使用抗生素提供选择依据.方法 用含有V因子、X因子的巧克力培养基分离培养流感嗜血杆菌,通过VITEK-2全自动微生物鉴定分析仪进行菌种鉴定.用琼脂扩散(K-B)法进行药敏试验.同时用头孢硝噻吩纸片检测β-内酰胺酶.结果 2年共分离到流感嗜血杆菌156株.其中以1岁以下婴幼儿及每年第2季度检出率最高.同时可见合并有肺炎链球菌等其他病原菌感染.药敏结果显示,复方磺胺的耐药率为75.9％,头孢克洛、头孢呋辛及阿奇霉素耐药率分别为81.3％、41.1％及30.4％.头孢曲松、左氧氟沙星、氨苄西林/克拉维酸敏感率均高于95.0％.β-内酰胺酶阳性率为66.7％.检出1株BLNAR.结论 流感嗜血杆菌在1岁以下的婴幼儿中感染率最高,并呈现明显的季节性变化.流感嗜血杆菌耐药机制复杂,产β-内酰胺酶率很高,仍然是流感嗜血杆菌的重要耐药机制.临床应根据药敏试验结果合理选用抗生素.

abstractsObjective To provide some references for clinically and rationally using antibiotics retrospectively analyzing the distribution characteristics and of haemophilus influenzae and antimicrobial susceptibility results at the department of pediatrics of our hospital from January,2016 to December,2017.Methods Chocolate agar plates containing V and X factors were used to isolate haemophilus influenzae.VITEK-2 compact was applied to identify the species.Antimicrobial susceptibility was tested by Kirby-Bauermethod.Beta lactamases were detected with nitrocefin disk.Results A total of 156 strains of haemophilus influenzae were isolated.In the second quarter of each year,the detection rate was the highest,especially in children under 1 year old.The combination with streptococcus pneumoniae was common.The antimicrobial susceptibility results showed that the resistant rates of haemophilus influenzae to Smz-Tmp,CEC,CXM,and AZM were 75.9％,81.3％,41.1％,and 30.4％.And the susceptibility rates of haemophilus influenzae to CRO,LVX,and AMC were all over 95.0％.The positive rate of β-lactamses was 66.7％.No BLNAR strain was detected.Conclusions Haemophilus influenzae infection rate is high in infants under 1 year old,and seasonally changes.The drug resistant mechanism is complicated;and high positive rate of β-lactamses still is the important mechanism.In clinical practice,antibiotics should be chosen according to antimicrobial susceptibility results.