HLAR粪肠球菌和屎肠球菌医院感染分布特征及耐药性分析

Analysis of the distribution and drug-resistance of High-level Aminoglycoside Resistance in Enterococcus spp in hospital infection

目的了解氨基糖甙类高水平耐药(HLAR)粪肠球菌和屎肠球菌在医院感染中分布特征及耐药现状。方法常规方法对本院2004年1月至2007年12月住院患者的各种临床标本进行培养分离,采用全自动微生物鉴定仪VITEK2对细菌进行鉴定及药敏检测。结果265株中引起医院感染的HLAR主要分布在ICU占26.8%(71/265),其次肾内科17.0%(45/265)及神经内科8.3%(22/265),感染以泌尿系统感染为主占30.2%(80/265),其中粪肠球菌占54.3%(144/265),屎肠球菌占45.7%(121/265),屎肠球菌对β-内酰胺类抗生素的耐药率明显高于粪肠球菌,但粪肠球菌对喹奴普汀/达福普汀的耐药率明显高于屎肠球菌(P<0.05),粪肠球菌及屎肠球菌对万古霉素、替考拉宁均敏感,对力奈唑烷耐药率为0及4.1%。结论HLAR粪肠球菌及屎肠菌对临床常用的抗生素耐药性有较大的差异,临床治疗时要合理选择抗生素,万古霉素、替考拉宁对其均有较好的体外抗菌活性。

Objective To investigate the distribution and drug-resistance of High-level Aminoglycoside Resistance in Enterococcus faecalis （efa）and Enterocoecus faecium （efm）in hospital infection. Methods The clinical specimens were collected from Jan 2004 to Dec 2007. Identification of the bacteria and Antimicrobial susceptibility test were performed on VITEK2 all-automatic microbiology analysis system. Results The strains were distributed mainly in intensive care units （26. 8% ）, kidney word （17.0%）and neurosurgery word （8. 3% ）. The urinary system was the main organ in the hospital infection（34. 7% ）. Of the 265 strains efa was 54. 3% and elm was 45.70%. The antimierobial resistance of efm was significantly higher than that of era to β- lactamase antibiotics, but the antimicrobial resistance of efa was higher than that of elm（ P 〈 0. 05 ）to Quinupristin/Dalfop ristin. The antimicrobial resistance of era and elm to Vaneomycin and Teicoplanin was 0, to Linzolid was 0,4. 1% respectively. Conclusion The resistance of High-level Amiuoglycoside Resistance in era and efm to antibiotics had different. Doctors should use of antibiotics reasonable, Vancomycin,Teicoplanin have better activity to efa and elm in vitro.