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[1082例住院呼吸道感染患儿鼻咽部标本中卡他莫拉菌的流行情况及分离株的耐药性]

[Prevalence of Moraxella catarrhalis in the nasopharyngeal specimen from 1 082 hospitalized children with respiratory infection and the drug resistance of the isolates].

作者信息

Tang Ping, Shi Wei, Zeng Hai-Ling, Ding Wei, Wang Cheng, Yao Kai-Hu, Wen De-Nian

机构信息

Department of Laboratory Medicine, People's Hospital of Zhongjiang County, Zhongjiang, Sichuan 618100, China.

出版信息

Zhongguo Dang Dai Er Ke Za Zhi. 2016 Aug;18(8):707-12. doi: 10.7499/j.issn.1008-8830.2016.08.007.

Abstract

OBJECTIVE

To investigate the prevalence of Moraxella catarrhalis in the nasopharyngeal region of children with respiratory infection and the sensitivity of Moraxella catarrhalis isolates to common antimicrobial drugs.

METHODS

Nasopharyngeal swabs were collected from 1 082 children with respiratory infection, and Moraxella catarrhalis strains were isolated. The E-test method and disc diffusion test were used to determine the sensitivity of these strains to 11 common antimicrobial drugs. The test results were interpreted with reference to the standards of European Committee on Antimicrobial Susceptibility Testing (EUCAST), Clinical and Laboratory Standards Institute (CLSI), and British Society for Antimicrobial Chemotherapy (BSAC). The nitrocefin disc method was used to detect whether the isolated strains produced β-lactamase.

RESULTS

Among the 1 082 children with respiratory infection, 77 (77/1 082, 7.12%) carried Moraxella catarrhalis in the nasopharyngeal region. All the strains produced β-lactamase. With reference to all the three standards, all the strains were sensitive to amoxycillin-clavulanate and had a susceptibility rate of >95% towards ciprofloxacin and tetracycline. According to the EUCAST and CLSI standards, the susceptibility rate of the strains towards sulfamethoxazole-trimethoprim was as high as 98.7%, and more than 80% of all strains were sensitive to the three cephalosporins detected; however, with reference to the BSAC standard, only 2.6% of the strains were sensitive to cefuroxime, with an intermediate rate of 44.2% and a drug resistance rate of 53.2%. The rate of resistance to ampicillin was 81.8%. According to the CLSI standard, the non-susceptibility rate of the strains to erythromycin was 79.2%, and according to the EUCAST or BSAC standards, their non-susceptibility rate reached 90.9%; more than one third of the strains (27/77, 35.1%) had a minimal inhibitory concentration of >256 mg/L.

CONCLUSIONS

All of the Moraxella catarrhalis isolates in the nasopharyngeal region of children with respiratory infection produce β-lactamase and are sensitive to amoxycillin-clavulanate. These isolates have high susceptibility rates to the third- and fourth-generation cephalosporins and sulfamethoxazole-trimethoprim, but most of the isolates are resistant to ampicillin, cefuroxime, and erythromycin.

摘要

目的

调查呼吸道感染儿童鼻咽部卡他莫拉菌的感染率以及卡他莫拉菌分离株对常用抗菌药物的敏感性。

方法

收集1082例呼吸道感染儿童的鼻咽拭子,分离卡他莫拉菌菌株。采用E试验法和纸片扩散法测定这些菌株对11种常用抗菌药物的敏感性。参照欧洲抗菌药物敏感性试验委员会(EUCAST)、美国临床和实验室标准协会(CLSI)以及英国抗菌化疗协会(BSAC)的标准对试验结果进行判读。采用硝噻吩纸片法检测分离菌株是否产生β-内酰胺酶。

结果

在1082例呼吸道感染儿童中,77例(77/1082,7.12%)鼻咽部携带卡他莫拉菌。所有菌株均产生β-内酰胺酶。参照所有三项标准,所有菌株对阿莫西林-克拉维酸敏感,对环丙沙星和四环素的敏感率>95%。根据EUCAST和CLSI标准,菌株对复方磺胺甲恶唑的敏感率高达98.7%,对检测的三种头孢菌素的敏感率超过80%;然而,参照BSAC标准,仅2.6%的菌株对头孢呋辛敏感,中介率为44.2%,耐药率为53.2%。对氨苄西林的耐药率为81.8%。根据CLSI标准,菌株对红霉素的不敏感率为79.2%,根据EUCAST或BSAC标准,其不敏感率达90.9%;超过三分之一的菌株(27/77,35.1%)最低抑菌浓度>256mg/L。

结论

呼吸道感染儿童鼻咽部的所有卡他莫拉菌分离株均产生β-内酰胺酶,且对阿莫西林-克拉维酸敏感。这些分离株对第三代和第四代头孢菌素以及复方磺胺甲恶唑的敏感率较高,但大多数分离株对氨苄西林、头孢呋辛和红霉素耐药。

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本文引用的文献

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Moraxella catarrhalis - pathogen or commensal?卡他莫拉菌——病原体还是共生菌?
Adv Exp Med Biol. 2011;697:107-16. doi: 10.1007/978-1-4419-7185-2_9.

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