返乡农民工子女肺部流感嗜血杆菌感染流行病学特征

目的比较分析返乡农民工子女与本地常住农民子女肺部感染流感嗜血杆菌的耐药性差异,为临床感染防治提供依据。方法调查2012年1月—2015年6月于某院诊断为肺部感染并进行痰细菌培养的本地区农民子女,将痰标本中分离出流感嗜血杆菌的患者按照是否随父母外出务工生活和学习分为返乡农民工子女组和本地常住农民子女组,分析两组患者感染特点并比较两组患者检出流感嗜血杆菌的耐药率。结果共调查患者6 989例,痰标本中共检出流感嗜血杆菌635株,检出率9.09%;返乡农民工子女组流感嗜血杆菌肺部感染发病率高于本地常住农民子女组(12.11%vs 8.47%,P0.01)。流动区域分布中跨4个省市流动的有12例(占8.39%),跨3个省市流动的有24例(占16.78%);地域分布以广东省为主(92例,占31.40%),其次为浙江省(87例,占29.69%)、江苏省(66例,22.53%)。返乡农民工子女组与本地区农民子女组均以3周岁以内患者为主,感染时间均以1~3月为主。返乡农民工子女组痰标本检出的流感嗜血杆菌对头孢噻肟、头孢吡肟、头孢克洛、四环素、氯霉素、克拉霉素、左氧氟沙星、氧氟沙星、环丙沙星的耐药率均较本地常住农民子女组高(均P0.05),产β-内酰胺酶率较本地常住农民子女组高(χ~2=24.35,P0.01)。结论返乡农民工子女组肺部感染患者检出的流感嗜血杆菌的耐药率高于本地常住农民子女组,其原因与其流动地区广,往返地域多,患者可通过呼吸道传播获得耐药性和往返地区的抗菌药物的使用习惯等因素有关。

Epidemiological characteristics of Haemophilus influenzae pulmonary infection in returned migrant workers’ children

ObjectiveTo compare difference in antimicrobial resistance of Haemophilia influenzae(H. influenzae) causing pulmonary infection between returned migrant workers’ children(RMWC) and local resident farmers’ children(LRFC).MethodsChildren from a local area who diagnosed with pulmonary infection and performed sputum bacterial culture in a hospital from January 2012 to June 2015 were investigated, those who isolated H. influenzae were divided into RMWC group and LRFC group according to whether they had ever followed their parents to work or study outside the local area or only stayed in the local area. Infection characteristics of two groups of children were analyzed, resistance rate of H. influenzae between two groups was compared.ResultsA total of 6 989 patients were investigated, 635 strains of H. influenzae were isolated from sputum specimens, isolation rate was 9.09%; incidence of H. influenzae pulmonary infection in RMWC group was higher than that of LRFC group (12.11% vs 8.47%, P<0.01). 12 children（8.39%） had ever migrated across 4 provinces and municipalities, 24 children（16.78%） had ever migrated across 3 provinces and municipalities; regional distribution was mainly in Guangdong Province (n=92, 31.40%），followed by Zhejiang Province（n=87， 29.69%）and Jiangsu Province （n=66，22.53%）. The age of both RMWC group and LRFC group were mainly less than three years old, infection time was mainly 1-3 month. Resistance rates of H. influenzae from sputum specimens of RMWC group to cefotaxime, cefepime, cefaclor, tetracycline, chloramphenicol, clarithromycin, levofloxacin, ofloxacin, and ciprofloxacin were all higher than those of LRFC group（all P＜0.05）， β lactamase producing rate was also higher （χ2=24.35，P＜0.01）.ConclusionResistance rate of H. influenzae isolated from RMWC group is higher than that of LRFC group with pulmonary infection, which may be related to extensive migration, patients get drug resistance through respiratory tract transmission, and antimicrobial use rule in different migrated regions.