肠球菌感染的临床分布及耐药特征

Infections Caused by Enterococcus:Clinical Distribution and Resistant Characteristics

目的:了解肠球菌在临床标本中的分布及对常用抗菌药物的耐药性,比较不同标本中肠球菌的耐药性,为临床治疗提供参考。方法:采用法国生物梅里埃公司VITEK-2 Compact对菌种鉴定及药敏试验,部分采用长沙天地人TDR-1002。结果:203株肠球菌主要来源于尿液、脓性分泌物、尿管,分别占43.8%、25.1%和18.2%,位居各类标本前3位:粪肠球菌对氨苄西林、氨苄西林/舒巴坦、环丙沙星、莫西沙星、亚胺培南的耐药率(15.6%、12.5%、30.2%、17.7%和9.4%)明显低于屎肠球菌(92.3%、91.0%、92.3%、89.7%和92.3%),而对四环素、喹奴普汀/达福普汀的耐药率及高水平庆大霉素协同(93.8%、92.7%、35.4%)则明显高于屎肠球菌(65.4%、9.0%、12.8%):未发现耐万古霉素肠球菌。结论:在临床标本中,肠球菌主要分布在尿液、脓性分泌物、留置尿管中,分离菌株以粪肠球菌和屎肠球菌为主,二者耐药谱明显不同。

Objective： To investigate the distrjbution and resistance of Enterococeus,and compare the resistance of them in different specimens.Methods： Bacteria were identified and Susceptibility test by VITEK-2 Compact and TDR-1002.Results：Of 203 clinical isolates, 43.8% were from urine, 25.1% were from pus 25.1% were from catheter, Resistance rates of E.faecalis to aropicillin ampicillinsulbactam,ciprofloxacin moxifloxacin and impenem were 15.6%,12.5%,30.2%,17.7% and 9.4%,respectively.They were lower than E.faeciu m（92.3%,91.0%,92.3%,89.7% and 92.3%）. Resistance rates of E.faecium to tetracyctine,quinupriistin-dalfopristin and gentamicin high level synergy were 65.4%,9.0%,and 12.8%, respectively.They were lower than E.faecalis（93.8%,92.7%,and 35.4%）.No strains were resistant to vancomycin.Conclusion： The distribution rate of Enterococcus strains isolated from urine,pus and catheter.E.faecalis and E.faecium were the main clinical isolates,Resistance of E.faecalis and E.faecium is diffrent.