临床常见肠球菌分布及耐药率分析

Surveillance on distribution and drug resistance of clinical common enterococci

目的：了解肠球菌的分布及耐药状况，尤其是庆大霉素高水平耐药（HLGR）肠球菌及万古霉素耐药肠球菌（VRE）的状况，为临床治疗提供依据。方法：对本院门诊及住院患者的标本中分离出的234株肠球菌，用英国SENSITIRE（先德）荧光快速微生物鉴定／药敏分析系统，按NC-CLS2001版自动分析。结果：泌尿系感染占45．7％，下呼吸道感染占18．4％，伤口感染占14．5％；HLGR分离率为39．7％，对万古霉素耐药的肠球菌分离率为8．5％，产β-内酰胺酶的肠球菌占6．4％；对常用抗生素的耐药率，屎肠球菌明显高于粪肠球菌。结论：肠球菌对万古霉素的耐药率最低，其次是亚胺培南，因其属内各种问的耐药性差异，应将其鉴定到种的水平。

Objective To investigate the distribution and drug resistance of enterococcus, especially high level gentamicin resistance enterococcus（HLGR） and vancomyein resistance enterococcus （VRE）, so as to provide guidance for clinical medication. Methods 234 strains of enterococci were isolated from out-patients and hospitalized patients in our hospital. SENSITIRE rapid fluorescence microbiological identification/drug sensitivity analytical system was adopted to identify and detect the drug resistance of the specimens. Results In all the 234 strains of enterococci, 107 cases were isolated from urinary tracts （45.7%）, 43 strains from lower respiratory tract （18.4%）, 34 strains from infected wound （14.5%）. The isolated rate of HLGR, VRE and beta-lactamase-producing enteroeocci was 39.7 %, 8.5 %and 6.4%respectively. Enterococous faecalis was more sensitive to common antibiotics than enterococcus faecium. Conclusion The rate of drug resistance to vancomycin is the lowest in enterococcus and next to imipenem. Identification to genus level should be made for clinical application because of the differences between category classifications.