249株肠球菌属对抗菌药物的敏感性分析

Susceptibility Analysis of 249 Enterococcus Strains

目的了解全身感染和泌尿系感染粪肠球菌、屎肠球菌对抗菌药物的敏感性,为临床提供治疗依据。方法采用琼脂稀释法对249株来自临床送检的无菌体液、血液及尿液分离出的肠球菌属进行药敏试验,测定其MIC值。结果249株肠球菌属中,粪肠球菌117株、屎肠球菌132株,粪肠球菌在尿中的分布68.4%高于屎肠球菌50.0%,而血液及其他无菌部位中分离的屎肠球菌(50.0%)高于粪肠球菌(31.6%);粪肠球菌对加替沙星、环丙沙星、青霉素G、氨苄西林、高浓度庆大霉素的敏感性均高于屎肠球菌,而屎肠球菌对米诺环素的敏感性(74.8%)明显高于粪肠球菌(23.7%);249株肠球菌属除1株粪肠球菌对万古霉素中度敏感外,对替考拉宁和利奈唑烷100.0%敏感;无论粪肠球菌还是屎肠球菌对红霉素几乎100.0%耐药;粪肠球菌对高浓度庆大霉素的敏感率39.5%高于屎肠球菌15.3%;血液中粪肠球菌对10种抗菌药物的敏感性高于尿液,血液中屎肠球菌对加替沙星、环丙沙星、青霉素G、氨苄西林和红霉素5种抗菌药物均100.0%耐药。结论粪肠球菌、屎肠球菌对不同的抗菌药物的敏感性差异有统计学意义,在治疗时,应根据耐药特点及菌种间的耐药性差异来选择相应的治疗方案,目前万古霉素、替考拉宁和利奈唑烷仍然是治疗肠球菌属引起感染的最好药物。

OBJECTIVE To investigate the susceptibility of Enterococcus faecalis and E. faecium isolated from system and urinary tract infected patients and provide data for anti-infection therapy. METHODS The susceptibility （MIC） of 249 Enterococcus strains was tested by agar dilution method. RESULTS All 249 strains of Enterococcus （117 strains of E. faecalis and 132 strains of E. faecium） were isolated from urinary tract or systemic infection patients. The isolated rate of E. faecalis （68.4%） was higher than that of E. faecium （50.0%） in urinary tract isolates. Meanwhile, the isolated rate of E. faecium（50. 0%） was obviously higher than that of E. faecalis （31.6%） in systemic infection isolates. The drug susceptibility rate of E. faecalis was higher than that of E. faeciurn to gatifloxacin, ciprofloxacin, penicillin, ampicillin and high-level gentamicin but lower for minocycline. All Enterococcus were susceptible to vancomycin, teicoplanin and linezolid. They were almost 100.0 % resistant to erythromycin. The susceptibility rate of E. faecalis（39.5%）was higher than E. faeciurn （15.3%） to high-level gentamicin. The susceptibility rate of E. faecalis isolated from blood was higher than the strains isolated from urinary tract to all antibiotics. E. faecium isolated form blood was almost 100% resistant to gatifloxacin, ciprofloxacin, penicillin, ampicillin and erythromycin. CONCLUSIONS The drug susceptibility of E. faecalis and E. faeciurn which cause systemic and urinary tract infection is different. The available therapy project should be selected based on the resistance character. At present, vancomycin, teicoplanin and linezolid are the best choice for treatment against the infection caused by Enterococcus.