肠球菌感染的临床分布特点和耐药性分析

Bacteral Distribution and Drug-resistance of Isolated Enterococci in Clinical Specimens

目的分析肠球菌在临床标本中的分布及对常用抗菌药物的耐药性,为临床治疗提供参考。方法应用Vitek微生物系统回顾性统计分析近3年我院肠球菌的分离及耐药情况。结果肠球菌的分离率为2.75%,分类以粪肠球菌为主,其次为屎肠球菌;肠球菌属对利福平、四环素、红霉素、莫西沙星、左氧氟沙星耐药率较高。而对万古霉素、利奈唑烷、替考拉宁仍然保持良好的敏感性。粪肠球菌对青霉素、氨苄西林、呋喃妥因、高浓度庆大霉素(GM500)、高浓度链霉素(S2000)的耐药率分别是23.3%,24.4%,12.2%,46.7%,38.8%,低于屎肠球菌的80%,84%,28%,68%,56%(p<0.05);屎肠球菌对四环素、氯霉素的耐药率分别为48%,28%低于粪肠球菌的85.6%,44.4%(p<0.05);结论临床标本中,肠球菌在泌尿生殖道标本中的分布最高,粪肠球菌和屎肠球菌的耐药谱明显不同,在重症感染时可选用万古霉素、替考拉宁、利奈唑烷进行治疗。

Objective To investigate the distribution and resistance of Enterococci isolated from clinic specimens in our hospital and to apply clinic some suggestions for treating infections. Methods The dates of Enterococci infection and its drug-resistance in recent three year(Oct. 2004 to Oct.2007) were analyzed by Vitek-32 automatic microbial analysis system. Results The isolation rate was 2.75%, the main strain of enterococci was Enterococcus faecalis. E.faecium was the second one. The drug-resistance rate of Enterococci to Rifampin, Tetracycline, Erythromycin, Moxifloxacin, Levofloxacin was high. But it was still sensitive to Vancomycin, Linezolid, Teicoplanin. The resistance rate of Enterococcus faecalis to Penicillin, Ampicillin, Nitrofurantoin the high concentrations of Gentamicin (GM500), the high concentration of Streptomycin (S2000) were 23.3%,24.4%,12.2%,46.7%,38.8%,respecitively.They were lower than E.faecium (80%,84%,28%,68% and 56%); The resistance rate of Enterococcus faecium to tetracycline, chloramphenicol were 48%, 28% ,Which were lower than the Enterococcus faecalis 85.6%, 44.4% (p<0.05). Conclusions The distribution rate of Enterococcus spp in genitourinary tract specimens is the highest. Resistance of E.faecalis and E.faecium is different. We should choose vancomycin,linezolid, teicoplanin in severe infection.