Hu Y Y, Yu S J, Liu G, Gao W, Yang Y H
Department of Microbiology and Immunology, Beijing Children's Hospital, P R China.
Acta Paediatr. 2002;91(2):136-40. doi: 10.1080/080352502317285108.
A study on the nasopharyngeal carriage and antimicrobial susceptibility of Haemophilus influenza among children was conducted in Beijing Children's Hospital from April to May 2000. The study included 292 children between 1 and 60 mo of age with acute upper respiratory tract infection. Nasopharyngeal swabs from these patients were cultured, and 105 Haemophilus influenzae strains were isolated, 3 of which were type b. Antibiotic susceptibility of the strains was determined using disk diffusion and E-tests and the results compared with those of isolates from children with pneumonia in 1999. The carriage rate of Haemophilus influenzae was 36.0% (105/292). It was found that 4.8% and 1.0% of isolates were resistant to ampicillin and cefaclor, respectively, and 5.7%, 16.2% and 77.1% were resistant to chloramphenicol, tetracycline, and sulphamethoxazole/trimethoprim, respectively. Amoxicillin/clavulanic acid, cefuroxime, ceftriaxone, azithromycin, and clarithromycin were uniformly active to all strains. Compared with the data from 1999, there was a significant increase in resistance to tetracycline (from 12.7% in 1999 to 16.2%) and sulphamethoxazole/trimethoprim (from 40.5% in 1999 to 77.1%).
H. influenzae isolates from outpatients in Beijing Children's Hospital had low ampicillin resistance and were sensitive to amoxicillin/clavulanic acid. Sulphamethoxazole/ trimethoprim resistance rates increased rapidly compared with those in the 1999 data. Further surveillance investigations are important for the choice of empiric therapy of acute respiratory tract infection.
2000年4月至5月在北京儿童医院对儿童流感嗜血杆菌的鼻咽部携带情况及抗菌药物敏感性进行了一项研究。该研究纳入了292名年龄在1至60个月的急性上呼吸道感染儿童。对这些患者的鼻咽拭子进行培养,分离出105株流感嗜血杆菌菌株,其中3株为b型。采用纸片扩散法和E试验测定菌株的抗生素敏感性,并将结果与1999年肺炎患儿分离株的结果进行比较。流感嗜血杆菌的携带率为36.0%(105/292)。发现分别有4.8%和1.0%的分离株对氨苄西林和头孢克洛耐药,而对氯霉素、四环素和磺胺甲恶唑/甲氧苄啶的耐药率分别为5.7%、16.2%和77.1%。阿莫西林/克拉维酸、头孢呋辛、头孢曲松、阿奇霉素和克拉霉素对所有菌株均有一致的活性。与1999年的数据相比,对四环素的耐药率显著增加(从1999年的12.7%增至16.2%),对磺胺甲恶唑/甲氧苄啶的耐药率也显著增加(从1999年的40.5%增至77.1%)。
北京儿童医院门诊患者分离出的流感嗜血杆菌对氨苄西林耐药性低,对阿莫西林/克拉维酸敏感。与1999年的数据相比,磺胺甲恶唑/甲氧苄啶的耐药率迅速上升。进一步的监测调查对于急性呼吸道感染经验性治疗的选择很重要。