南通地区和其他地区临床分离的肠球菌耐药性研究分析

Analysis of antimicrobial resistance of clinical isolates of enterococci from Nantong and other areas in Jiangsu Province

目的:探讨和分析肠球菌的耐药表型,为临床合理用药提供客观依据。方法:采集南通4家综合性医院和省内10家三级医院2003—2006年分离的不重复的2936株肠球菌,按照CLIS推荐的方法和判断标准进行纸片扩散药敏试验,并用WHONET5专用软件进行分析。结果:南通和其他地区分离的肠球菌中,粪肠球菌、屎肠球菌分别占80.4%、15.1%和78.1%、16.2%;居前5位分离出肠球菌的临床标本依次为尿液33.7%和28.4%;痰液22.9%和16.3%;脓性分泌物9.8%和14.6%;血液4.4%和5.O%;胆汁3.O%和4.5%。南通和其他地区粪肠球菌对万古霉素、替考拉宁、氨苄西林、高浓度庆大霉素的耐药率分别为2.0%、5.1%;1.4%、3.7%;17.0%、24.00/0;47.3%、49.2%。屎肠球菌对万古霉素、替考拉宁、氨苄西林、高浓度庆大霉素的耐药率分别为1.4%、2.2%;2.7%、3.1%;64.2%、67.9%;64.9%、62.3%。耐万古霉素肠球菌占3.5%。结论:临床分离的肠球菌株以粪肠球菌为主;屎肠球菌对多种抗菌药物较粪肠球菌具有更强的耐药性;肠球菌对万古霉素、替考拉宁的耐药率最低。

Objective ：To analyze the antimicrobial resistance phenotype of entericocci to provide impersonal information. Methods ： Disk diffusion method according to CLIS was used to test the antimicrobial resistance of 2936 enterococcal isolates from 4 comprehensive hospitals in Nantong and 10 grade 3 hospitals in other areas of China from years 2003 to 2006. The laboratory data was analyzed by WHONET5 statistic software. Results： Enterococcus. Faecalis isolates and E. faecium isolates accounted for 80.4% and15.1% of the entericoccus isolates in Nantong and 78.1% and 16.2% in other areas, respectively. The entericoccus isolates from urine, sputum, secretion with pus, blood, and bile accounted for top five 33.7%,22.9%,9.8%, 4.4%, and 3.0% of the entericoccus isolates in Nantong and 28.4%,16.3%,14.6%,S.0%, and 4.5% in other areas respectively. The resistance rates of E. faecalis to vancomycin, teicoplanin ampicillin, and high-level gentamicin were 2.0%v 1.4%, 17.0%, and 47.3% in Nantong , and 5.1%,3.7%,24%, and 49.2% in other areas; The resistance rates of E. faecalis to vancomycin, teicoplanin, ampicillin, and high-level gentamicin were 1.4%,2.7%,64.2%, and 64.9% in Nantong and 2.2%,3.1%,67.9%, and 62.3% in other areas respectively. The vancomycin-resistant rate of the total isolates of entericocci was 3.5%. Conclusions ： Enterococcus faecium is the main species in the entericoccus isolates from clinical samples. E. faecium, compared with E. faecalis, resists many antimicrobial agents more strongly. Both of E. faecalis and E. faecium show the least resistance to vancomycin and teicoplanin.