医院感染肠球菌的临床分离及耐药性分析

Clinical isolates and antimicrobial resistant characteristics of enterococcus nosocomial infection

目的了解医院感染肠球菌的临床分离及其对常用抗生素的耐药性,指导临床合理用药,提高医院感染的治愈率。方法对本院感染标本中分离出的136株肠球菌,进行常规分离和纸片扩散法进行药敏试验,并以"WHONET5.5"软件对试验数据进行分析处理。结果在136株肠球菌中,以粪肠球菌为主(77.94%),主要引起泌尿系感染。药敏试验结果显示:肠球菌对各种抗生素的耐药性差异有统计学意义,粪肠球菌对抗生素的耐药率最低是万古霉素(1.6%),最高是四环素(79.0%)。屎肠球菌对大部分抗生素的耐药率明显高于粪肠球菌。结论医院感染肠球菌属细菌常发生在免疫功能低下、有严重基础疾病、使用过侵袭性操作的患者,肺部感染最常见。肠球菌对常用抗生素耐药率较高,屎肠球菌的耐药性明显高于粪肠球菌。万古霉素敏感性高,是治疗肠球菌感染的最佳抗生素。

Objective To study the isolation of enterococcus and its drug resistance to common antimicrobial agents for guiding the clinical rational administration, and to PrOvide reference for clinical therapy. Methods Isolates of enterocoecus （136） collected from infectious samples in our hospital were identified and the susceptibility test was performed. WHONET 5.5 software was used for analyzing the data. Results Among the 136 strains, there were 106 strains of E. faecal （77.94%）, 20 strains of E. faecium （14.71%）. Among all infective specimens in the secretion of respiratory tract, the 145 isolates of E. faecalis showed resistant rates of 79.0% and 1.6% for tetracycline and vancomycin respectively. According to the result of drug susceptibility test, the resistant rate of E. faecium to the other 8 kinds of antibiotics was higher than that of E. faecal except for tetracycline and vancomycin. Conclusion Enterococcus nosocomial infection usually occurrs in the patients with lower immunity, serious basal diseases and invasive operations. Lower respiratory tract is the commonest infective site. Enterococcus has high resistance to frequently used antibacterial agents. The resistant rates of E. faecium are higher than those of E. faecalis. Vancomycin is the best choice to treat enterococci nosocomial infections.