248株肠球菌对抗菌药物的敏感性分析

Susceptibility analysis of 248 enterococcus strains

目的了解全身感染和伤口分泌物感染的粪肠球菌、屎肠球菌对抗菌药物的敏感性,为临床提供治疗依据。方法采用微量稀释法对248株自临床送检的血液、尿液及其他标本分离的肠球菌进行药敏试验,测定其MIC值。结果248株肠球菌属中,粪肠球菌187株、屎肠球菌61株,两者的比例为3.06∶1。粪肠球菌对氨苄西林、环丙沙星、左氧氟沙星、青霉素G的敏感率为63.2%～99.1%,高于屎肠球菌的16.7%～31.9%;屎肠球菌对四环素的敏感率为40.3%,高于粪肠球菌的19.3%;2种肠球菌对红霉素的敏感率分别是13.9%和8.3%,对利奈唑烷和万古霉素的敏感性均>95%;分离自伤口分泌物的粪肠球菌对氨苄西林、环丙沙星、左氧氟沙星、青霉素G、四环素的敏感性略高于血液分离菌,分离自伤口分泌物的屎肠球菌对氨苄西林、红霉素、高浓度庆大霉素、青霉素G、四环素的敏感性低于血液分离菌,伤口分泌物和血液分离得到屎肠球菌对利奈唑烷均100.0%敏感。结论粪肠球菌、屎肠球菌对不同的抗菌药物的敏感性差异较大,治疗时应根据耐药特点及菌种间的耐药性差异选择相应的药物和方案,目前万古霉素和利奈唑烷仍然是治疗肠球菌属感染的有效药物。

Objective To investigate the susceptibility of Enterococcus faecalis and E. faecium isolated from system and wound infected patients, and to provide reference for clinical therapy. Methods The susceptibility （MIC） of 248 Enterococcus strains from blood, urine and others were tested by broth microdilution test. Results All 248 strains of Enterococcus （187 strains of E. faecalis and 61 strains of E. f aecium, the ratio is 3.06 ： 1） were isolated. The drug susceptibility rate of E. faecalis（63.2%-99.1%） was higher than that of E. faeciurn （16.7%--31.9%） to ampicillin, ciprofloxaein, levofloxaein, penicillin G but lower for tetracycline. The drug susceptibility rate of Enterococcus were 95% to vancomyein and linezolid. The drug susceptibility rate of Enterococcus faecalis and E. faecium were 13.9% and 8.3% to erythromycin, respectively. The susceptibility rate of E. faecalis isolated from blood was a little lower than the strains isolated from wound to ampieillin, eiprofloxaein, levofloxacin, penicillin G and tetracycline. The susceptibility rate of E. faecium isolated from blood was higher than the strains isolated from wound to ampicillin, erythroein, high-level gentamicin, penicillin G and tetracycline. E. faecalis isolated from blood and wound was almost 95 % sensitive to linezol- id. E. faecium isolated from blood and wound was almost 100% sensitive to linezolid. Conclusion The drug suscepti- bility of E. faecalis and E. faecium which cause systemic and wound infection is different . The available therapy project should be selected based on the resistance character. At present, vancomycin and linezolid are the active drug for treat- ment against the infection caused by Enterococcus.