| Objective To investigate the distribution and antibiotic resistance of Haemophilus,so as to provide a basis for controlling hospital infection and using antibiotics properly.Method Haemophilus were isolated and cultured from a total of 41811 specimens except feces in our hospital from 2007 to 2010. Nitrocefin test was used to detectβ-laetamase. Susceptibility tests to eleven antibiotics were carried out. Data was analysised by WHONET5.5 and SPSS 17.0 software.The infection status and antibiotics-resistance patterns of Haemophilus was analysised.Result A total of 1573 strains of Haemophilus were isolated from 41811 specimens except feces, most of which were isolated from patients with respiratory infection and 40.24% isolated from Pneumology Department,and the detected rate accounted for 3.76%,in which Haemophilus influenzaes accounted for 610,Haemophilus parainfluenzaes 956, Haemophilus haemolyticus 6, Haemophilus paraphrophilus.1; The detected rate of Haemophilus parainfluenzae isolated from 2010 was higher than that from 2007 to 2009, but there was no difference in antibiotics-resistance.There was statistically significant difference in isolation rate of Haemophilus among four seasons, the infection rate in winter was higher than that in spring,summer and autumn. Theβ-lactamase-positive rate was 33.00%,408β-lactamase-positive strains were resistant to ampicillin,109β-lactamase-negative strains were resistant to ampicillin; The sensitive rates of BLPAR to ampicillin/sulbatan,amoxicillin/clavulanic acid,cefuroxime and Aztreonam were all higher than that of BLNAR, and the sensitive rate of BLNAR to azethromycin was higher than that of BLPAR. The resistance rates of Haemophilus to ampicillin and SMZ+TMP were 37.7%,42.4% respectively. The non-susceptibility rate to ceftriaxone(CRO), azethromycin(AZM), meropenem(MEM), Levofloxacin(LEV),and aztreonam(ATM) was 1.1-26.3%, LEV+AZM+ATM was the majority multi-resistance pattern in the four antibacterial drugs;The sensitive rate of Haemophilus parainfluenzae to ampicillin/sulbatan,amoxicillin/clavulanic acid,cefuroxime, chloramphenicol and cotrimoxazole was all higher than that of Haemophilus influenzae, and the sensitive rate of Haemophilus influenzae to azethromycin was higher than that of Haemophilus parainfluenzae,but there was no significant difference between them;Theβ-lactamase-positive rate when multi-resistant to 11 kinds of usual antibacterial agents is significantly higher than that of non-multiresistant strains.Conclusiion1. The isolated rate of Haemophilus isolates presented an increasing trend in the main, in which Haemophilus influenzae and Haemophilus parainfluenzae were the major strains.Most of them were isolated from respiratory specimens.Over a half of them were isolated from specimens of Pneumology Department and department of pediatrics.2.The detected rate of Haemophilus isolates was highest in winter.As the seasons changed, the detected rate of Haemophilus changed.3. In the antimicrobial susceptibility test of Haemophilus, the third generation cephalosporins and carbapenems was the most sensitive(>90%), which can be used as an alternative after the failure of conventional treatments, and prefered in department of pediatrics; meropenem should be preferred when caused by BLNAR's infection,meanwhile,it should be noted that BLNAR had more antibiotics-resistance than BLPAR.4.Haemophilus isolates which were insensitivity to ceftriaxone, aztreonam, meropenem, azithromycin, levofloxacin were found. Among the multi-resistance of Haemophilus isolates to them, LEV+AZM+ATM was the highest one, Chloramphenicol and Cefuroxime should be the first choice when this occurs, but Chloramphenicol should be used cautiously.5. Theβ-lactamase-positive rate of Haemophilus were trending up,and the mechanism of multi-resistance may be related toβ-lactamase when multi-resistant to the eleven kinds of usual antibacterial agents. It should be paid highly attention. |
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