粪肠球菌的临床分布及耐药性探讨

The Clinical Distribution and Drug Resistance of Enterococcus Faecalis

目的:本文旨在了解粪肠球菌在临床上分布特点,分析其对16种常用抗生素的耐药特点,指导临床合理选用抗生素。方法:采用全自动微生物鉴定仪VITEK-32鉴定系统,对临床标本中分离出的242株粪肠球菌进行鉴定,使用K-B法对242株粪肠球菌进行药敏试验,对其药敏数据进行统计分析。结果:在242株粪肠球菌中,泌尿系统感染最高(50.7%),其次为腹腔胆道感染(20.4%)、伤口感染(16.5%)、其他感染(12.4%);肠球菌耐药率最低者为替考拉宁(0%),其次为万古霉素(2%)、左旋氧氟沙星(11.1%)、呋喃妥因(11.5%);最高是头孢唑啉(100%),其次为复方新诺明(97.5%)、丁胺卡那霉素(95%)、克林霉素(94.6%)。结论:粪肠球菌是泌尿道、腹腔、胆道等感染的重要病原菌,且在医院感染的重要性越来越受到临床的重视,在抗感染治疗时应根据药敏试验的实际情况综合临床各方面资料,合理选用抗生素,减少耐药菌株的产生和耐药基因的传播。

Objective To explore the clinical distribution aspects of Enterococcus faecalis and its resistance to sixteen kinds of routine antibiotics which can be used as guidelines for using antibiotics rationally. Methods 242 strains of Enterococcus faecalis were identified by VITEK-32 and their susceptibilities were detected by K-B test. Then, the experimental results were analyzed objectively by statistic method. Results on the one hand, from the analysis of the clinical distribution, we know that the highest infection rate of Enterococcus faecalis is in urological system （50.7%） which is followed by abdominal cavity and bile duct（20. 4% ） ,the wound （ 16.5% ） and other parts of the body（ 12.4% ）. On the other hand, we know that the low resistant rate of Enterococcus faecalis to Teicoplanim, Vancomycin, Levofloxacin, Nitrofurantoinis 0% ,2%, 11.1%, 11.5% respectively and the high resistantrate to Cefazolin, Trimethoprim/sulfamethoxazzole, Amikacin, Ofloxacinis 100% , 97.5% , 95%, 94.6%. Conclusion Enterococcus faecalis is one kind of important pathogenic bacterium of urinary tract, abdominal cavity and bile duct. The hospital acquired infection caused by it is getting more and more attentions. So antibiotics should be used rationally and practically according to the antimicrobial susceptibility test with the hope to decrease the resistant strains and the spread of the resistant gene.