耐万古霉素肠球菌感染的临床分析

Vancomycin-resistant Enterococcus Infection: A Clinical Analysis

目的探讨耐万古霉素肠球菌感染的易感因素及防治措施。方法对我院15例耐万古霉素肠球菌感染的病例进行回顾性调查分析。结果耐万古霉素肠球菌感染患者中可以是社区感染,但医院感染较多,老年患者、住ICU,基础疾病以消化系统疾病及住院时间长而易致感染,感染部位以下呼吸道为多,多伴有耐药葡萄球菌同时培养阳性。结论强效广谱抗菌药物的大量应用及使用有创机械通气是耐万古霉素肠球菌感染的重要危险因素;治疗可交替使用β-内酰胺类、氨基糖苷类及喹诺酮类抗菌药物;严格的隔离消毒措施可防止该感染在医院内蔓延。

OBJECTIVE To search for the sensitive factors of infection by vancomycin-resistant Enterococcus（VRE） as well as the corresponding prevention measures. METHODS Investigation and analysis had been conducted for 15 cases of infection induced by VRE. RESULTS Some of the cases had been infected in communities, but most been infected in hospital, including the old patients in ICU, patients with underlying diseases or respiratory diseases and inpatients staying long in hospital. The infection site was mainly lower respiratory tract, together with the positive results of drug-resistant staphylococci culture. CONCLUSIONS Use of large amount of strong effect broadspectrum antibiotic as well as use of invasive mechanical ventilation are the risk factors causing infection by VRE. Alternative use of antibiotic of β-1actamases, amino-glycosides and quinolones can cure the infection, besides, strict isolation and disinfection measures can prevent the infection from spreading in hospital.