【摘要】 目的 了解2015—2021年国内不同地区临床分离流感嗜血杆菌和卡他莫拉菌的分布及对抗菌药物的耐药性，为临床合理用药和预防耐药性提供有效依据。方法 收集2015—2021年中国CHINET细菌耐药性监测网流感嗜血杆菌和卡他莫拉菌进行分析，采用纸片扩散法或商品化药敏试验自动测定仪，按CHINET统一技术方案进行抗菌药物敏感性试验。结果 2015—2021年共收集嗜血杆菌属细菌43 642株和卡他莫拉菌16 191株。嗜血杆菌属细菌占CHINET耐药监测总体细菌的2.91%，占革兰阴性杆菌的4.07%。40 437株流感嗜血杆菌中，儿童株66.89%、成人株33.11%,90%以上分离自呼吸道标本，53.79%检出产β内酰胺酶；儿童株对阿奇霉素、氨苄西林、头孢呋辛和甲氧苄啶-磺胺甲唑的耐药率高于成人株；产酶株对所测试抗菌药物的耐药率明显高于不产酶株；检出不产β内酰胺酶但对氨苄西林耐药流感嗜血杆菌779株。16 191株卡他莫拉菌中，儿童株（80.06%）多于成人株（19.94%）；卡他莫拉菌对阿莫西林-克拉维酸和头孢呋辛均很敏感，细菌耐药率<2.0%。结论 产β内酰胺酶所致的耐药流感嗜血杆菌的出现给临床抗感染治疗带来了挑战。因此，开展流感嗜血杆菌的耐药监测，以指导临床合理用药非常重要。建议各临床微生物实验室应积极完善开展流感嗜血杆菌的药敏试验，加强该菌的耐药监测。更多还原

【Abstract】 Objective To investigate the distribution and antimicrobial resistance profiles of clinically isolated Haemophilus influenzae and Moraxella catarrhalis in hospitals across China from 2015 to 2021, and provide evidence for rational use of antimicrobial agents. Methods Data of H. influenzae and M. catarrhalis strains isolated from 2015 to 2021 in CHINET program were collected for analysis, and antimicrobial susceptibility testing was performed by disc diffusion method or automated systems according to the uniform protocol of CHINET. The results were interpreted according to the CLSI breakpoints in 2022. Betalactamases was detected by using nitrocefin disk. Results From 2015 to 2021, a total of 43 642 strains of Haemophilus species were isolated, accounting for 2.91% of the total clinical isolates and 4.07% of Gram-negative bacteria in CHINET program. Among the 40 437 strains of H. influenzae, 66.89% were isolated from children and 33.11% were isolated from adults. More than 90% of the H. influenzae strains were isolated from respiratory tract specimens. The prevalence of β-lactamase was 53.79% in H. influenzae strains. The H. influenzae strains isolated from children showed higher resistance rate than the strains isolated from adults. Overall,779 strains of H. influenzae did not produce β-lactamase but were resistant to ampicillin(BLNAR). Beta-lactamase-producing strains showed significantly higher resistance rates to these antimicrobial agents than the β-lactamase-nonproducing strains. Of the 16 191M. catarrhalis strains, 80.06% were isolated from children and 19.94% isolated from adults. M. catarrhalis strains were mostly susceptible to both amoxicillin-clavulanic acid and cefuroxime, evidenced by resistance rate lower than 2.0%. Conclusions The emergence of antibiotic-resistant H. influenzae due to β-lactamase production poses a challenge for clinical anti-infective treatment.Therefore, it is very important to implement antibiotic resistance surveillance for H. influenzae and guide rational antibiotic use. All local clinical microbiology laboratories should actively improve antibiotic susceptibility testing and strengthen antibiotic resistance surveillance for H. influenzae.更多还原