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目的:探讨浙江省三门县儿童呼吸道流感嗜血杆菌(Hi)的生物分型及耐药性。方法:回顾性分析2013年1月至2014年12月在浙江省三门县人民医院儿科门诊与住院部治疗的呼吸道感染患儿7 140例,采用无菌负压吸引法采集新鲜痰液,进行流感嗜血杆菌培养、分离,进行生物分型,使用生物鉴定仪、鉴定卡、药敏试剂盒进行药敏试验并对其β-内酰胺酶进行检测。结果:7 140例儿童呼吸道感染患儿分离出337株Hi;生物学分型以Ⅱ型和Ⅲ型所占比例最大,二者占全部Hi菌株的91.4%;337株Hiβ-内酰胺酶阳性率为32.64%(110/337);Hi的各类抗菌药物耐药性检测中氨苄西林的耐药率最高;Hi对阿莫西林/克拉维酸、四环素、头孢噻肟、利福平、氯霉素等的敏感率均大于90%,对氧氟沙星、头孢呋辛、头孢克洛等敏感率均大于80%。结论:2013年—014年三门县儿童呼吸道Hi生物学分型以Ⅱ型、Ⅲ型为主,且Ⅱ型产β-内酰胺酶的几率最高,Hi对氨苄西林的耐药率最高,对阿莫西林/克拉维酸、四环素、头孢噻肟、利福平、氯霉素等的敏感率均大于90%,阿莫西林/克拉维酸是治疗Hi感染的首选药物。
Objective: To investigate the biological typing and drug resistance of Haemophilus influenzae in children in Sanmen County of Zhejiang Province. Methods: A retrospective analysis of 7 140 cases of children with respiratory tract infection treated in pediatric outpatient department and inpatient department of Sanmen County People’s Hospital of Zhejiang Province from January 2013 to December 2014 was performed. Fresh sputum was collected by sterile vacuum suction method. Haemophilus influenzae culture, separation, bio-typing, the use of biological identification device, identification card, drug sensitivity kit susceptibility testing and beta-lactamase detection. Results: A total of 337 strains of Hi were isolated from 7 140 children with respiratory tract infection. The highest proportion of type Ⅱ and Ⅲ was found in biological typing, which accounted for 91.4% of all Hi strains. The positive rate of Hiβ-lactamase in 337 strains was 32.64% (110/337). The resistance rates of ampicillin in various antimicrobial drug resistance tests of Hi were the highest. Hi was the most resistant to amoxicillin / clavulanic acid, tetracycline, cefotaxime, rifampin, chloramphenicol And other sensitive rates were greater than 90%, ofloxacin, cefuroxime, cefaclor and other sensitive rates were greater than 80%. Conclusion: The type of respiratory Hi Hippocampus was mainly type Ⅱ and type Ⅲ in Sanmen County between 2013 and 014, and the type Ⅱ β-lactamase was the highest, while Hi had the highest rate of ampicillin resistance. Sensitivity of moxillin / clavulanic acid, tetracycline, cefotaxime, rifampicin, chloramphenicol, etc. were all over 90%. Amoxicillin / clavulanic acid was the first choice for the treatment of Hi infection.