临床分离粪肠球菌和屎肠球菌的耐药性监测

SURVEILLANCE OF DRUG RESISTANCE OF ENTEROCOCCUS FAECALIS AND ENTEROCOCCUS FAECIUM STRAINS ISOLATED FROM INPATIENTS

目的:了解粪肠球菌和屎肠球菌对抗菌药物的耐药性,为临床提供治疗依据。方法:对住院及门诊病人送检样本中培养分离出316株肠球菌(粪肠球菌126株,屎肠球菌190株)的感染分布与耐药情况进行分析。采用稀释法进行药物敏感试验,结果按美国临床实验室标准化研究所标准判定。结果:屎肠球菌对青霉素G的耐药率最高(93.7%),其次为红霉素、氨苄西林和环丙沙星。粪肠球菌对奎奴普丁/达福普汀耐药率最高为(74%),其次为四环素、红霉素和环丙沙星。粪肠球菌和屎肠球菌对利奈唑胺和万古霉素的耐药率均低于(2%),替考拉宁的耐药率最低均为(0)。结论:粪肠球菌和屎肠球菌对不同抗菌药物的耐药率有较大差异,在抗感染治疗前应先做细菌培养和药物敏感试验,依据报告结果合理选用抗菌药物。

Objective:To get knowledge of antimicrobial resistance of Enterococcus Faecalis and Enterococcus Faecium to antibiotics, and further provide basis for treatment. Methods:316 strians of enterococci composed of 126 strains of enterococcus faecalis and 190 strains of enterococcus faecium were cultured and isolated from samples of inpatients and outpatients,and distribution of infection and antimicrobial resistance were analyzed. Agar dilution method was used to do antibiotic susceptibility test,and the results were determined based on the standard of Clinical and Laboratory Standard Institute ( CLSI 2012 ) . Results:The resistance rate of enterococcus faecium to penicillin G ( 93 . 7%) is the highest among all of the antimicrobial tested, followed by erythromycin, ampicillin, ciprofloxacin. The resistance rate of enterococcus faecium to quinupristin/dalfopristin(74%) was the highest among all of the antimicrobials tested,followed by tetracycline,erythromycin and ciprofloxacin. The resistance rate of enterococcus faecalis and enterococcus faecium to linezolid and vancomycin were all lower than 2%,and that to teicoplanin was the lowest(0%) . Conclusions:The resistance rate of enterococcus faecalis and enterococcus faecium to different kinds of antibiotics differed much. Bacterial culture and antimicrobial susceptibility tests should be performed before anti-infection treatment initiated and reasonable antibiotics be selected based on antimicrobial susceptibility test report.