223株常见肠球菌的临床分布和耐药性分析

Bacteria distribution and drug-resistance of 223 isolated enterococci in clinical specimens

目的分析常见肠球菌在临床标本中的分布及对常用抗菌药物的耐药性,为临床治疗提供参考。方法采用法国梅里埃生物API鉴定系统进行菌种鉴定,并采用K-B纸片扩散法进行体外耐药监测及统计耐药率。结果肠球菌的临床分离率为8.78%,分类以粪肠球菌为主,其次为屎肠球菌,肠球菌属对利福平、四环素、红霉素、达福普汀、氯霉素耐药率较高。而对万古霉素、替考拉宁和呋喃妥因仍然保持良好的敏感性。粪肠球菌对青霉素、氨苄西林、左旋氧氟沙星的耐药率分别为2.4%、2.4%、5.9%,均低于屎肠球菌的90.7%、88.9%、13.0%,屎肠球菌对四环素、氯霉素的耐药率分别为51.9%和48.1%,均低于粪肠球菌的95.3%和78.1%。结论临床标本中,肠球菌在泌尿生殖道标本中的分布最高,粪肠球菌和屎肠球菌的耐药谱明显不同,在重症感染时可选用万古霉素、替考拉宁和呋喃妥因进行治疗。

Objective To investigate the distribution and resistance of common Enterococci isolated from clinical specimens in our hospital and to apply some suggestions for treating infections to the clinic.Methods The microbiological system API was used to identify bacteria and the drug-resistance in vitro was determined by K-B methods.Results The clinical isolation rate of enterococci was 8.78%. The main strain of enterococci was Enterococcus faecalis. Enterococcus faecium was the second one.The drug-resistance rate of Enterococci to Rifampin,Tetracycline,Erythromycin,Dalfopristin,Chloramphenicol was high.But it was still sensitive to Vancomycin,Teicoplanin,Nitrofurantoin.The resistance rate of Enterococcus faecalis to Penicillin,Ampicillin,Levofloxacin were2.4%,2.4% and 5.9% respectively.They were lower than Enterococcus faecium （90.7%, 88.9% and 13.0%）; The resistance rate of Enterococcus faecium to tetracycline,chloramphenicol were 51.9%,48.1%.Which were lower than the Enterococcus faecalis 95. 3%,78.1%.Conclusions The distribution rate of Enterococcus spp in genitourinary tract specimens is the highest.Resistance of Enterococcus faecalis and Enterococeus faecium is different.We should choose vancomycin,teicoplanin or Nitrofurantoin in severe infection.