苏州地区住院儿童呼吸道卡他布兰汉菌感染流行病学特点及耐药性分析

doi:10.12372/jcp.2022.21e1254

摘要/Abstract

摘要： 目的分析苏州地区住院儿童呼吸道卡他布兰汉菌（MC）感染流行病学特点及药敏变迁情况,以期为临床合理使用抗生素提供指导。方法收集2008年1月至2020年12月因呼吸道感染住院患儿的鼻咽分泌物标本细菌培养结果,根据年龄、季节、基础疾病情况等进行分组,监测MC感染流行特点并动态观察MC药敏变迁情况。结果近13年共收集27 472例呼吸道感染患儿的鼻咽分泌物标本,其中742份标本培养出MC,MC总检出率为2.7%。2008年至2020年MC的年度检出率差异有统计学意义（P<0.01）,以2017年度检出率较高。不同年龄组间MC检出率差异有统计学意义（P<0.01）,以3~5岁检出率较高,>5岁检出率较低。春、夏、秋、冬各季节MC检出率差异有统计学意义（P<0.01）,检出率以秋季较高,夏季较低。27 472例患儿中有基础疾病者占18.9%。有基础疾病组MC检出率为1.8%,低于无基础疾病组（2.9%）,差异有统计学意义（P<0.01）。总结2013—2020年的药敏试验结果,发现MC对利福平、氯霉素、头孢噻肟、四环素和左氧氟沙星高度敏感,8年间药敏试验敏感率差异有统计学意义（P<0.05）。MC对阿莫西林、复方新诺明也有较高的敏感率。结论苏州地区MC感染患儿以<5岁人群为主,秋季为好发季节,MC对多种抗生素维持较高的敏感率;儿童呼吸道MC感染建议首选阿莫西林治疗。

关键词: 卡他布兰汉菌, 呼吸道, 儿童

Abstract: Objective To analyze the epidemiological characteristics and drug sensitivity changes of respiratory tract infections in hospitalized children caused by Moraxelle Catarrhalis (MC) in Suzhou area, so as to provide information for the rational use of antibiotics in clinic.Methods The results of bacterial culture in nasopharyngeal secretions of hospitalized children with respiratory tract infection from January 2008 to December 2020 were collected. The children were divided into groups according to age, season and basic diseases. The epidemic characteristics of MC infection were monitored and the changes of MC drug sensitivity were dynamically observed.Results A total of 27 472 specimens of nasopharyngeal secretions from children with respiratory tract infections were collected in the past 13 years, of which 742 specimens were cultured with MC, and the total detection rate of MC was 2.7%. There were significant differences in MC detection rates among different years from 2008 to 2020 (P<0.01), and the detection rate in 2017 was higher. There was significant difference in the detection rate of MC among different age groups (P<0.01). The detection rate was higher in 3-5 years, and lower in >5 years. The difference of MC detection rate among spring, summer, autumn and winter was statistically significant (P<0.01) and the detection rate was higher in autumn and lower in summer. Among 27 472 children, 18.9% had basic diseases. The detection rate of MC in the group with concomitant diseases was 1.8%, lower than that in the group without concomitant diseases (2.9%), and the difference was statistically significant (P<0.01). The results of drug susceptibility tests from 2013 to 2020 were summarized, and it was found that MC was highly sensitive to rifampicin, chloramphenicol, cefotaxime, tetracycline and levofloxacin. The sensitivity rate of drug sensitivity test was statistically significant among 8 years (P<0.05). MC also had high sensitivity rate to amoxicillin and cotrimoxazole.Conclusions The children infected with MC in Suzhou were mainly less than 5 years old. Autumn was the frequent season of onset, and MC had a high sensitivity rate to multiple antibiotics. Amoxicillin is recommended as the first treatment for MC infection of respiratory tract in children.

Key words: Moraxelle Catarrhalis, respiratory tract, child

武银银, 张利亚, 陶云珍, 黄莉莉, 季伟. 苏州地区住院儿童呼吸道卡他布兰汉菌感染流行病学特点及耐药性分析[J]. 临床儿科杂志, 2022, 40(4): 279-283.

WU Yinyin, ZHANG Liya, TAO Yunzhen, HUANG Lili, JI Wei. Epidemiological characteristics and drug resistance analysis of respiratory tract infections in hospitalized children caused by Moraxelle catarrhalis in Suzhou area[J]. Journal of Clinical Pediatrics, 2022, 40(4): 279-283.

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抗生素	2013年	2014年	2015年	2016年	2017年	2018年	2019年	2020年	χ²值	P
抗生素	（n=26）	（n=79）	（n=78）	（n=76）	（n=89）	（n=80）	（n=57）	（n=79）	χ²值	P
阿莫西林	26(100)	79(100)	77(98.7)	76(100)	89(100)	80(100)	57(100)	79(100)	-	0.420¹⁾
氨苄西林	0(0)	0(0)	1(1.3)	0(0)	0(0)	0(0)	0(0)	0(0)	-	0.420¹⁾
复方新诺明	22(84.6)	76(96.2)	72(92.3)	64(84.2)	80(89.9)	75(93.8)	47(82.5)	74(93.7)	13.96	0.052
利福平	24(92.3)	79(100)	77(98.7)	76(100)	89(100)	80(100)	57(100)	79(100)	-	0.002¹⁾
氯霉素	24(92.5)	79(100)	77(98.7)	75(98.7)	89(100.0)	80(100)	57(100)	79(100)	-	0.007¹⁾
头孢呋辛	14(53.8)	53(67.1)	51(65.4)	47(61.8)	60(67.4)	56(70.0)	40(70.2)	55(69.6)	3.83	0.799
头孢噻肟钠	25(96.2)	77(97.5)	75(96.2)	76(100)	89(100)	80(100)	57(100)	79(100)	-	0.026¹⁾
四环素	26(100)	74(93.7)	75(96.2)	71(93.4)	88(98.9)	79(98.8)	57(100)	79(100)	-	0.040¹⁾
头孢克洛	8(30.8)	40(50.6)	34(43.6)	33(43.4)	47(52.8)	48(60.0)	34(59.7)	46(58.2)	13.76	0.056
左氧氟沙星	25(96.2)	77(97.5)	70(89.7)	72(94.7)	87(97.8)	77(96.3)	57(100)	79(100)	-	0.021¹⁾