临床分离肠球菌的耐药性监测与分析

Resistance of Enterococci: A Surveillance and Analysis

目的 监测临床分离的 14 0株肠球菌对 16种常用抗菌药物的敏感性 ,为临床治疗肠球菌感染提供依据。方法 采用琼脂稀释法测定各抗菌药物对肠球菌的 MIC,计算 MIC50 、MIC90 和敏感率 ,采用快速硝噻吩纸片显色法对 14 0株肠球菌进行β-内酰胺酶测定。结果 万古霉素、替考拉宁对粪肠球菌和屎肠球菌的敏感性最高 ,均为10 0 % ,粪肠球菌对氨苄西林 /舒巴坦、亚胺培南和氨苄西林敏感率分别为 91.9%、90 .8%和 90 .8% ;屎肠球菌对氨苄西林 /舒巴坦、亚胺培南和氨苄西林分别为 92 .7%、82 .9%和 90 .2 % ;粪肠球菌、屎肠球菌以及其他肠球菌对头孢吡肟的敏感率最低分别为 14 .9%、9.8%和 0 ;青霉素和氨苄西林对粪肠球菌、屎肠球菌的药敏结果可推测对亚胺培南的敏感性。结论 万古霉素和替考拉宁仍是治疗肠球菌感染最有效的药物 。

OBJECTIVE To survey and analyze the susceptibility of 140 enterococci to 16 antibacterial agents,and to determine the enterococci of high-level gentamicin and streptomycin. METHODS MIC were determined by (agar) dilution method on Mueller-Hitton agar according to the approved National Committee for Clinical (Laboratory) Standards, and calculated the MIC_(50), MIC_(90) and the rate of susceptibility, and examined for (β-lactamase) production with the rapid chromogenic disk test. RESULTS All of TBXEnterococcus faecalis and (E. faecium) were susceptible to vancomycin and teicoplanin, the susceptibility of E. faecalis to ampicillin/(sulbactam, )imipenem and ampicillin was 91.9%, 90.8% and 90.8%, respectively; for E. faecium, the susceptibility was (92.7%, )82.9% and 90.2%, respectively. for E. faecalis, high-level gentamicin and streptomycin (resistant) strains were 69.8% and 42.5%, respectively; for E. faecium, 29.3% and 7.3%, respectively. The susceptibility of E. faecalis, E. faecium and other enterococci was lowest to cefepime (14.9%, 9.8% and 0, (respectively), )and the susceptibility of enterococci to ampicillin or penicillin accurately predicted the in vitro (activity) of imipenem. CONCLUSIONS At present, vancomycin and teicoplanin are the most effective antibacterial agents yet to treat the infection of enterococci.