广州地区1999～2003年肠球菌的耐药性调查

Antibiotic Resistance of Enterococcus in Guangzhou During 1999-2003

目的了解广州地区1999～2003年肠球菌的耐药性,为临床合理用药提供理论依据. 方法用常规的方法对广州地区12所医院临床标本进行培养、分离及鉴定,严格按照NCCLS的标准,用K-B法进行药物敏感性试验,WHONET5及SPSS软件卡方检验对资料进行统计分析. 结果广州地区1999～2003年肠球菌,对受试的8种抗生素的敏感率分别为万古霉素(VAN)84.3%～100.0%(耐药全部表现为中度敏感)、氨苄西林(AMP)72.5%～90.4%、青霉素(PEN)61.3%～81.6%、氯霉素(CHL)42.8%～59.2%、四环素(TET)12.5%～38.7%、环丙沙星(CIP)10.3%～23.5%、红霉素(ERY)3.0%～8.2%,庆大霉素(500 μg/ml GEN)34.8%～52.5%,产β-内酰胺酶的肠球菌为1.3%～2.4%,1999～2003年间除红霉素的体外抗菌活性差异无显著性(P>0.05)外,其余的几种抗生素差异均有显著性(P<0.05). 结论氨苄西林、青霉素、万古霉素是治疗肠球菌的首选经验用药,>45.0%的肠球菌不能用糖肽类的抗生素与青霉素、氨苄西林协同治疗,未发现耐万古霉素的肠球菌.

OBJECTIVE To investigate the antibiotic resistance of Enterococcus in Guangzhou during 1999-2003 to direct clinical treatment. METHODS To make antimicrobial susceptibility test （AST） by K-B for samples collected from 12 hospitals in Guangzhou. The results were read according to the standard of NCCLS. The data were processed by WHONET 5 and the statistics were done by SPSS. RESULTS During 1999-2003 the sensiltive rates to 8 antibiotics commonly used in clinical treatment, respectively, were vancomycin （VAN） 84.3-100.0%, ampicillin （AMO） 72.5-90.4%, penicillin （PEN） 61.3-81.6%, chloramphenicol （CHL） 42.8-59.2%, tetracycline （TET） 12.5-38.7%, ciprofloxacin 10.3-23.5%, erythromycin （ ERY ） 3.0-8.2%, gentamycin （GEN 500μg/ml） 34.8-52.5%, β-lactamase producing Enterococcus were 1.3-2.4M. The differences of resistance of Enterococcus to 7 antibiotics were significant except ERY in the five years （P〈0. 05）. CONCLUSIONS AMP, PEN and VAN are the first experienced antibiotics for Enterococcus. Over 45. 0% of Enterococcus are inactively to glycopeptides, penicillin and ampicillin in their combination therapy. The Enterococcus resistant to vancomycin isn＇t found.