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目的了解2010~2012年蚌埠医学院第一附属医院呼吸道嗜血杆菌(Haemophilus)分布和耐药性变迁,为临床合理用药提供依据。方法用哥伦比亚巧克力平板培养基分离嗜血杆菌,卫星试验初步鉴定,嗜血杆菌鉴定卡(NH卡)确认鉴定菌株,纸片琼脂扩散法(Kirby~Bauer)做药敏试验并检测β-内酰胺酶。结果 2010~2012年共分离出394株嗜血杆菌,其中流感嗜血杆菌126株(31.2%),副流感嗜血杆菌268株(68.8%),嗜血杆菌β-内酰胺酶的产生率为40.8%;流感嗜血杆菌对头孢呋辛钠、环丙沙星、氨苄西林、复方新诺明的耐药率较高并有逐年升高趋势,副流感嗜血杆菌对头孢呋辛钠、环丙沙星、左氧氟沙星、氨苄西林、复方新诺明也有明显的高耐药率和逐年升高的趋势。两种细菌对三代四代头孢菌素、加酶抑制剂青霉素和碳青霉烯类药物的耐药率明显较低。结论呼吸道流感嗜血杆菌的检出率低于副流感嗜血杆菌的检出率,治疗这类细菌的感染可首选三代四代头孢菌素和加酶抑制剂青霉素。临床微生物室应加强对呼吸道嗜血杆菌常规分离培养及药敏试验,为临床医生合理使用抗生素提供依据,降低嗜血杆菌的耐药率。
Objective To understand the distribution of Haemophilus and the change of drug resistance in the First Affiliated Hospital of Bengbu Medical College from 2010 to 2012 and provide the basis for clinical rational drug use. Methods Haemophilus was isolated from Columbia chocolate medium and identified by satellite test and identified by Haemophilus identification card (NH card). Kirby Bauer was used for drug susceptibility test and β-lactam Enzymes. Results A total of 394 strains of Haemophilus were isolated from 2010 to 2012, including 126 (31.2%) Haemophilus influenzae strains, 268 (68.8%) Haemophilus parainfluenzae and 68 40.8%; Haemophilus influenzae to cefuroxime sodium, ciprofloxacin, ampicillin, cotrimoxazole resistance rate is higher and there is an upward trend year, Haemophilus parainfluenzae to cefuroxime sodium, ring Ciprofloxacin, levofloxacin, ampicillin, cotrimoxazole also have a significant high rate of resistance and the trend of increasing year by year. Two kinds of bacteria on the third generation and fourth generation cephalosporins, enzyme inhibitors penicillin and carbapenem drug resistance rates were significantly lower. Conclusion The detection rate of Haemophilus influenzae is lower than the detection rate of Haemophilus parainfluenzae. The third and fourth generation cephalosporins and the enzyme inhibitor penicillin are the best choice for the treatment of such bacteria. Clinical Microbiology room should strengthen the routine isolation and culture of Haemophilus influenzae and drug susceptibility testing, provide reasonable basis for clinicians to use antibiotics and reduce the rate of Haemophilus resistance.