Latorre Cristina, Sanfeliu Isabel
Servicio de Microbiología, Hospital universitario Sant Joan de Déu. Barcelona. España.
Enferm Infecc Microbiol Clin. 2003 Mar;21(3):126-30. doi: 10.1016/s0213-005x(03)72900-0.
The purpose of this study was to investigate the antigenic and biochemical characteristics, antibiotic susceptibility, and mechanisms for acquiring resistance of Haemophilus influenzae strains isolated in several Catalan hospitals, to determine the current situation regarding this microorganism in our area.
Serotype, biotype and betalactamase production, as well as susceptibility to eight antimicrobial agents (ampicillin, cefuroxime, cefotaxime, cefixime, clarithromycin, co-trimoxazole, chloramphenicol and ciprofloxacin) were determined in 497 H. influenzae strains isolated from 1 May 1999 to 30 April 2000 in 12 Catalan hospitals.
Among the total, 97.5% of strains were nontypable and 50% of the encapsulated strains were serotype b (all isolated from children under 5 years old). There was a predominance of biotype II, though no age or pathologic tropism was found among any of the biotypes. Our series confirms the previously reported trend to decreasing betalactamase mediated ampicillin resistance in our area, mainly in strains from pediatric patients. More betalactamase negative ampicillin-resistant strains (BLNAR) were isolated in children than in adults. One ciprofloxacin-resistant strain was detected.
Infections caused by encapsulated H. influenzae strains are infrequent in our area and the relative importance of serotype b is decreasing. Mechanisms for acquiring ampicillin resistance other than betalactamase production are emerging. Surveillance of ciprofloxacin susceptibility is required to predict therapeutic failures with this quinolone.
本研究的目的是调查在加泰罗尼亚几家医院分离出的流感嗜血杆菌菌株的抗原和生化特性、抗生素敏感性以及获得耐药性的机制,以确定我们地区这种微生物的现状。
对1999年5月1日至2000年4月30日期间在12家加泰罗尼亚医院分离出的497株流感嗜血杆菌菌株,测定其血清型、生物型和β-内酰胺酶产生情况,以及对八种抗菌药物(氨苄西林、头孢呋辛、头孢噻肟、头孢克肟、克拉霉素、复方新诺明、氯霉素和环丙沙星)的敏感性。
在所有菌株中,97.5%为不可分型,50%的包膜菌株为b血清型(均从5岁以下儿童中分离出)。生物型II占优势,不过在任何生物型中均未发现年龄或病理嗜性。我们的系列研究证实了我们地区先前报道的β-内酰胺酶介导的氨苄西林耐药性下降趋势,主要见于儿科患者的菌株。儿童中分离出的β-内酰胺酶阴性氨苄西林耐药菌株(BLNAR)比成人多。检测到1株环丙沙星耐药菌株。
在我们地区,由包膜流感嗜血杆菌菌株引起的感染并不常见,b血清型的相对重要性正在下降。除β-内酰胺酶产生外,获得氨苄西林耐药性的机制正在出现。需要监测环丙沙星敏感性,以预测使用这种喹诺酮类药物的治疗失败情况。