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首页> 中文期刊> 《中国感染与化疗杂志》 >2010中国CHINET流感嗜血杆菌和卡他莫拉菌耐药性监测

2010中国CHINET流感嗜血杆菌和卡他莫拉菌耐药性监测

         
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Objective To investigate the antibiotic resistance of clinical strains of Haemopkilus influenzae (HI) and Moraxella catarrhalis (MC) isolated from different regions in china during 2010. Methods Clinical strains of HI and MC were collected from 9 general hospitals and 2 children's hospitals, Kirby-Bauer method and agar dilution method were used to determine the susceptibilities of these strains. Results were analyzed according to the CLSI 2010 breakpoints. Beta-lactamases were detected by nitrocefin disk test. Results Among the 734 clinical strains of HI, the resistance rate to trimethoprim-sulfamethoxazole, ampicilliru ampicillin-sulbactam, chloramphenicol, ciprofloxacin was 64, 5% , 31, 7% , 14, 5% , 12. 5% and 14. 2% , respectively, About 90% of these HI strains were still susceptible to cefotaxime, amoxicillin-clavulanic acid, azithromycin, or cefuroxime. The resistance rate to ampicillin and the prevalence of β -lactamases in the HI strains from children (35.1%, 30. 1%) were higher than in the strains from adults (26. 6% and 24. 1 % ). The resistance rate to ciprofloxacin was 4. 0% in the HI strains from children , significantly lower than in the strains from adults (17. 0% , P<0, 05), The overall prevalence of β-lactamases was 28. 1 % in the HI strains. There are 39 HI strains resistant to ampicillin but β-lactamase negative. The 214 clinical strains of MC kept highly susceptible to second and third cephalosporins, amoxillin-clavulanic acid, levofloxacin, or trimethoprim-sulfamethoxazole (96. 7%-100%). About 45. 1 % of these MC strains were resistant to azithromycin. The prevalence of β-lactamases was 96. 7% in these MC strains. Conclusions HI and MC are stably susceptible to cephalosporins, beta-lac tarn-lactamase inhibitor combinations as well as quinolones. Production of β-lactamase is still the major mechanism of ampicillin resistance in these two bacterial species. Further research is needed to explore the mechanism of antibiotic resistance in the β-lactamase-negative and ampicillin resistant strains.%目的 了解2010年我国不同地区临床分离流感嗜血杆菌和卡他莫拉菌的耐药性.方法 收集9所综合性医院和2所儿童医院临床分离的734株流感嗜血杆菌和214株卡他莫拉菌,分别采用Kirby-Bauer纸片法和琼脂稀释法作药敏试验,依照CLSI 2010版标准判断结果.头孢硝噻吩纸片法测定β内酰胺酶.结果 734株临床分离流感嗜血杆菌对甲氧苄啶-磺胺甲恶唑的耐药率最高,达64.5％、其次对氨苄西林、氨苄西林-舒巴坦、氯霉素和环丙沙星的耐药率分别为31.7％、14.5％、12.5％和14.2 ％；该菌对头孢噻肟、阿莫西林-克拉维酸、阿奇霉素以及头孢呋辛的耐药率均在10％以下(4.2％～8.9％).儿童分离株对氨苄西林的耐药率和产酶率(35.1％、30.1％)均高于成人分离株(26.6％、24.1％),对环丙沙星的耐药率(4.0％)低于成人分离株(17.0％),耐药率的差异均有统计学意义(P＜0.05).β内酰胺酶总检出率28.1％.39株为氨苄西林耐药而β内酰胺酶阴性.214株卡他莫拉菌对第二代和第三代头孢菌素、阿莫西林-克拉维酸、左氧氟沙星、甲氧苄啶-磺胺甲(口恶)唑均呈现高度敏感(96.7％～100％),但对阿奇霉素的耐药率为45.1％.该菌产β内酰胺酶的检出率为96.7％.结论 流感嗜血杆菌和卡他莫拉菌对头孢菌素类、酶抑制剂复方制剂以及喹诺酮类抗菌药物保持高度敏感性;产β内酰胺酶仍是上述2种细菌对氨苄西林耐药的重要耐药机制；但氨苄西林耐药而β酰胺酶阴性的流感嗜血杆菌的分离株较前增多,其耐药机制有待进一步研究.

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