成人住院患者流感嗜血杆菌感染的临床特征及耐药性变迁

Clinical characteristics of hospitalized adult patients with Haemophilus influenzae infection and change of drug resistance

    摘要
  • 摘要:
    目的 分析2022-2024年住院成人肺炎患者呼吸道标本检出的流感嗜血杆菌的临床特征及耐药性变化。
    方法 收集2022年1月-2024年12月在佛山市三水区人民医院住院的1 462例成人肺炎患者的临床资料及呼吸道标本检出流感嗜血杆菌的药敏数据, 利用SPSS 22.0及WHONET 5.6统计软件, 回顾性分析流感嗜血杆菌感染患者临床特征及耐药性变化情况。
    结果 1 462例住院患者共检出流感嗜血杆菌感染223例, 其中男性患者流感嗜血杆菌检出率高于女性患者(16.38% vs. 12.00%), 比较有统计学差异(P＜0.05)；夏季及秋季检出率较高(P＜0.05)；慢性阻塞性肺疾病患者占比34.08%；223株流感嗜血杆菌药敏试验结果中β-内酰胺酶阳性率为63.23%, β-内酰胺酶阴性氨苄西林耐药菌株检出率为9.86%；2022-2024年流感嗜血杆菌对阿奇霉素的耐药率有统计学差异(χ2=6.715, P=0.035), 2024年流感嗜血杆菌对阿奇霉素的耐药率较高(40.77%)。
    结论 住院成人肺炎患者感染流感嗜血杆菌以男性、慢性阻塞性肺疾病患者居多, 春、冬季易发。在流感嗜血杆菌耐药性分析中, β-内酰胺酶阳性率及氨苄西林耐药率较高, 经验性使用青霉素类药物需谨慎；阿奇霉素耐药性呈逐年升高趋势, 流感嗜血杆菌的多重耐药可能对临床诊疗带来新挑战。

     

    Abstract:
    OBJECTIVE To investigate the clinical characteristics of Haemophilus influenzae strains isolated from respiratory trace specimens of the hospitalized adult patients with pneumonia and analyze the change of drug resistance from 2022 to 2024.
    METHODS The clinical data and drug susceptibility testing data for the H. influenzae strains isolated from respiratory tract specimens were collected from the 1 462 adult patients with pneumonia who were hospitalized in Foshan Sanshui District People′s Hospital from Jan. 2022 to Dec. 2024. The clinical characteristics of the patients with H. influenzae infection and the change of drug resistance were retrospectively analyzed with the use of SPSS 22.0 and WHONET 5.6 software.
    RESULTS Totally 223 of 1462 hospitalized patients were diagnosed with H. influenzae infection, the detection rate of H. influenzae was 16.38% among the male patients, higher than 12.00% among the female patients, and there was significant difference (P < 0.05); the detection rate was higher in summer and autumn (P < 0.05). The patients with chronic obstructive pulmonary disease accounted for 34.08%. The result of drug susceptibility testing for the 223 strains of H. influenzae showed that the positive rate of β-lactamase was 63.23%, and the isolation rate of β-lactamase-negative ampicillin-resistant strains was 9.86%. There was significant difference in the drug resistance rate to azithromycin among the H. influenzae strains isolated from 2022 to 2024(χ2=6.715, P=0.035), and the drug resistance rate of the H. influenzae strains to azithromycin was higher in 2024 (40.77%).
    CONCLUSIONS The male patients and the patients with COPD are dominant among the hospitalized adult pneumonia patients with H. influenzae infection, which is prevalent in spring and winter. The drug resistance analysis shows that the positive rate of β-lactamase and the drug resistance rate to ampicillin are high, and it should be aware of the empirical use of penicillin. The drug resistance rate to azithromycin is increased year by year; the multidrug-resistance in the H. influenzae strains may pose new challenge to the clinical diagnosis and treatment.

     

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