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目的了解2000—2003年北京、上海、广州细菌耐药监测项目中,小于5岁呼吸道感染儿童鼻咽部携带氨苄西林(AMP)耐药流感嗜血杆菌(Haemophilusinfluenzae,Hi)的分子流行病学情况。方法对上述呼吸道感染儿童鼻咽部分离的899株Hi进行AMP敏感性检测,筛选出74株AMP耐药Hi,采用巢式PCR荚膜分型和玻片凝集法,对AMP耐药菌株进行b型Hi(Haemophilusinfluenzaetypeb,Hib)检测,并用脉冲电场凝胶电泳(pulsed-fieldgelelectrophoresis,PFGE)和多重PCR两种方法,对AMP耐药菌株进行基因分型。结果74株AMP耐药Hi中,有2株Hib(占2.7%)。PFGE分型74株AMP耐药Hi中有38种基因型,具有克隆传播趋势的有5型,包括41株Hi(占55.4%)。其中菌株数最多的为A型,有18株,占24.3%,以2002年上海地区为主。多重PCR分型结果有31型,多重PCR与PFGE分型结果一致率为63.5%。结论北京、上海、广州三地区四年内小于5岁的呼吸道感染儿童鼻咽部携带的AMP耐药Hi有55.4%的菌株存在克隆传播。
Objective To investigate the molecular epidemiology of ampicillin-resistant Haemophilus influenzae (Hi) in the nasopharynx of children younger than 5 years of age from 2000 to 2003 in Beijing, Shanghai and Guangzhou bacterial resistance surveillance programs . Methods To detect the AMP sensitivity of 899 isolates isolated from the nasopharynx of children with respiratory tract infection, 74 strains of drug-resistant Hi were screened out, and nested PCR capsid typing and slide agglutination were used to detect the AMP resistant strains. (Hi), and the strains resistant to AMP were genotyped by pulsed-field gelelectrophoresis (PFGE) and multiplex PCR. Results Of the 74 AMP-resistant Hi, two Hibs (2.7%) were found. There were 38 genotypes in 74 strains of AMP-resistant Hi in PFGE genotypes, 5 genotypes with clonal spread trend, including 41 strains of Hi (55.4%). Among them, the largest number of strains was type A, with 18 strains accounting for 24.3%, mainly in Shanghai in 2002. Multiplex PCR typing results were 31 type, multiplex PCR and PFGE typing results were 63.5%. Conclusions 55.4% of strains with AMP resistance in nasopharynx of children younger than 5 years of age in four years in Beijing, Shanghai and Guangzhou are cloned and spread.