肠球菌属医院感染调查分析

Hospital-acquired Infection by Enterococcus:An Investigation Analysis

目的了解医院感染肠球菌属的部位分布、易感因素及耐药情况,为临床预防控制医院感染及合理用药提供参考。方法对医院2001-2005年在各类感染标本中分离出的65株肠球菌属进行分析和药敏检测。结果65株肠球菌属中屎肠球菌36株,粪肠球菌29株;易感系统疾病前3位为消化、循环、损伤;分布部位依次为泌尿道、下呼吸道、手术部位,相关的侵入性操作泌尿道插管、气管插管、手术部位;药敏试验除万古霉素、替考拉宁外,粪肠球菌对氨苄西林、高浓度链霉素、左氧氟沙星、呋喃妥因有较高的敏感性;屎肠球菌对氯霉素、四环素有抗菌活性,临床检出耐万古霉素肠球菌(VRE)2例。结论肠球菌属在尿液中最易检出,相关的侵入性操作现患率高,屎肠球菌分离率高,且耐药性强,万古霉素仍然是对肠球菌属最敏感的药物。

OBJECTIVE To investigate and know the site distribution, susceptible factors and antibiotic resistant condition in hospital-acquired infection by Enterococcus so as to provide reference for clinical preventive control and for reasonable uses of medicine. METHODS Sixty five Enterococcus strains isolated from different infection specimens in the hospital from 2001 to 2005 were analyzed, and examined their sensitivity to medicines. RESULTS Among 65 Enterococcus strains there were 36 strains of Enterococcus faecalis and 29 strains of E. faecium. The first three susceptible site diseases were alimentary, circulatory and injury. The site distributions were urinary tract, lower respiratory tract and surgical incisions. Related aggressive operations included urethra intubation, tracheal intubation, and surgery. Except for vancomycin and teicoplanin, E. faecalis was sensitive to ampicillin, high-level streptomycin, levofloxacin and nitrofurantoin, and E. faecium had antibacterial activity to chloramphenicol and tetracycline. There were 2 vancomycin-resistant Enterococcus （VRE） cases detected. CONCLUSIONS It is the easiest to examine and find Enterococcus in urine and the prevalence rate is high after related aggressive operations. The isolation rate of E. faecium is high and it has strong antibiotic resistance. Vancomycin is still the most sensitive medicine to Enterococcus.