Lerman S J, Kucera J C, Brunken J M
Pediatrics. 1979 Sep;64(3):287-91.
We selected 16 schools representing a broad socioeconomic cross-section of metropolitan Omaha and obtained nasopharyngeal cultures for Haemophilus influenzae from 1,084 healthy 4- to 7-year-old children. We found that 34.2% of the children carried nontypable strains and 2.0% carried type b strains. Carriage rates were not influenced by recent illness, family size, or number of people sharing a bedroom. The prevalence of ampicillin-resistant H influenzae in the sample population was 0.9% for nontypable strains and 0.4% for type b strains; it was not significantly different in the group of children who had recently used beta-lactam antibiotics. One child carried a nontypable strain which was resistant to both chloramphenicol and tetracycline, the first chloramphenicol-resistant H influenzae detected in Omaha. A survey of healthy children may be a useful method for projecting a community's risk of disease caused by ampicillin-resistant H influenzae. Among the nasopharyngeal isolates from healthy children, 2.7% of nontypable strains and 18.2% of type b strains were resistant to ampicillin (P less than .01). During the same five-month period in Omaha, clinical failure in the treatment of otitis media with ampicillin was uncommon and four (20.0%) of 20 cases of H influenzae type b bacteremia and meningitis were caused by ampicillin-resistant organisms.
我们选取了代表奥马哈大都市广泛社会经济层面的16所学校，从1084名4至7岁健康儿童中获取了流感嗜血杆菌的鼻咽培养样本。我们发现，34.2%的儿童携带不可分型菌株，2.0%的儿童携带b型菌株。携带率不受近期疾病、家庭规模或共用卧室人数的影响。样本人群中，不可分型菌株对氨苄西林耐药的流感嗜血杆菌患病率为0.9%，b型菌株为0.4%；在近期使用过β-内酰胺类抗生素的儿童组中，患病率无显著差异。一名儿童携带了一株对氯霉素和四环素均耐药的不可分型菌株，这是在奥马哈检测到的首例耐氯霉素流感嗜血杆菌。对健康儿童进行调查可能是预测社区由耐氨苄西林流感嗜血杆菌引起疾病风险的一种有用方法。在健康儿童的鼻咽分离株中，2.7%的不可分型菌株和18.2%的b型菌株对氨苄西林耐药（P小于0.01）。在奥马哈的同一五个月期间，用氨苄西林治疗中耳炎的临床失败情况并不常见，20例b型流感嗜血杆菌菌血症和脑膜炎病例中有4例（20.0%）是由耐氨苄西林的病原体引起的。
