成人与儿童社区获得性肺炎临床分离流感嗜血杆菌分子流行特征

Molecular epidemiological characteristics of clinical Haemophilus influenzae isolates from adults and children with community-acquired pneumonia

    摘要
  • 摘要:
    目的 分析本地区成人与儿童社区获得性肺炎(CAP)患者临床分离流感嗜血杆菌(Hin)的分子流行特征，为有效预防和治疗Hin感染提供理论依据。
    方法 统计2023年1月-2024年12月新疆生产建设兵团医院呼吸与危重症医学科和儿科因CAP住院患者痰液中Hin的阳性检出率，比较成人与儿童CAP患者Hin的临床分布特征与药敏结果，并对72株Hin的荚膜类型、耐药基因和多位点序列分型(MLST)进行检测。
    结果 儿童CAP患者Hin阳性检出率高于成人CAP患者(P＜0.05)，分别为9.46%与2.71%；儿童CAP患者Hin的流行趋势较成人明显，秋、冬季高发，以13~17岁儿童为主要检出人群(12.67%)。两类患者中分离的Hin产β-内酰胺酶的阳性检出率分别是74.71%和90.17%，其中，对氨苄西林的耐药率最高(73.86%和92.57%)，儿童株对上述两种β-内酰胺类抗菌药物的耐药率高于成人株(P＜0.05)。72株Hin中不可分型Hin为主要流行类别(94.45%)，以blaTEM-1介导的产β-内酰胺酶为主要耐药机制，MLST分型鉴定以CC155(ST-155)、CC11(ST-103)和CC107(ST-1002)型为主要分型。
    结论 本地区成人与儿童CAP患者主要检出产β-内酰胺酶的不可分型Hin，儿童检出率高于成人，以秋、冬季高发，ST-155是优势克隆型，对氨苄西林高度耐药，临床应引起重视。

     

    Abstract:
    OBJECTIVE To investigate the molecular epidemiological characteristics of clinical Haemophilus influenzae (Hin) isolates from adults and children with community-acquired pneumonia (CAP) so as to provide theoretical bases for effective prevention and treatment of Hin infection.
    METHODS The patients who were hospitalized in respiratory and critical care medicine department and pediatrics department of Xinjiang Production and Construction Corps Hospital due to CAP from Jan. 2023 to Dec. 2024 were enrolled in the study, and the positive rates of Hin in sputum specimens were statistically analyzed. The clinical distribution and results of drug susceptibility testing for Hin strains were observed and compared between the adults with CAP and the children with CAP. The capsular types, drug resistance genes and multilocus sequencing typing (MLST) subtypes were detected for 72 strains of Hin.
    RESULTS The positive rate of Hin was higher among the children with CAP (9.46%) than among the adults with CAP (2.71%). The Hin was more prevalent among the children with CAP than among the adults, it was highly prevalent in autumn and winter, with the population dominated by the children aged between 13 and 17 years old (12.67%). The positive rate of β-lactamase-producing Hin strains was 74.71% among the adult patients and 90.17% among the children, respectively; the drug resistance rates to ampicillin were highest (73.86% and 92.57%), the drug resistance rates of the strains isolated from the children to the two types of β-lactams were higher than those of the strains isolated from the adults (P < 0.05). The non-typeable Hin strains (94.45%) were the predominant type among the 72 strains of Hin, the production of β-lactamase mediated by blaTEM-1 was the major drug resistance mechanism. The result of MLST showed that CC155 (ST-155), CC11 (ST-103) and CC107 (ST-1002) were the main subtypes.
    CONCLUSIONS The β-lactamase-producing non-typeable Hin strains are dominant among the Hin strains isolated from the adults and children with CAP in this area. The isolation rate of the strains is high among the children than among the adults. The strains are highly prevalent in autumn and winter, and ST-155 is the predominant clone type. The strains are highly resistant to ampicillin, which should be attached great importance to.

     

    • HTML全文
    • 参考文献(26)
    • 相关文章
    • 施引文献
  • 资源附件(0)

/

返回文章
返回
下载中心