无锡地区2008～2009年肠球菌属的临床分布特征及耐药性分析

Clinical Distribution and Drug Resistance Analysis of Enterococcus in Hospital in Wuxi Area 2008-2009

目的 研究无锡地区肠球菌属的临床分布特征及耐药表型,为临床治疗提供参考.方法 回顾性总结2008～2009年无锡地区两家三甲医院各类标本中分离出的170株肠球菌,并对其分布特点、检出率及药敏结果进行统计、分析.结果 肠球菌属中以屎肠球菌比例最高（52.9%）,粪肠球菌次之（41.2%）.来自尿标本中的肠球菌最多（77.0%）,其次为胆汁（6.0%）和血液（4.0%）.药敏结果表明,肠球菌属总体耐药水平较高,但对万古霉素和利奈唑胺的耐药率极低.屎肠球菌对奎奴普丁/达福普丁、氯霉素、四环素的耐药性（1.1%～20.2%）明显低于粪肠球菌（31.3%～82.1%）,而对其它多数抗生素的耐药率（66.3%～93.3%）则明显高于粪肠球菌（7.5%～75%）,两者比较差异有统计学显著性意义（P＜0.05）.屎肠球菌的6重耐药率与8重耐药率均明显高于粪肠球菌.结论 无锡地区的肠球菌属感染以屎肠球菌、粪肠球菌为主,屎肠球菌对大多数抗生素的耐药率高于粪肠球菌.临床治疗应根据药敏试验合理应用抗菌药物,或者选用利奈唑胺治疗耐万古霉素的肠球菌所引起的感染.

Objective To study the characteristics of clinical distribution and the drug resistance phenotype of Enterococcus in the hospital of Wuxi area and to provide reference for clinical therapy. Methods The distribution and drug resistance of 170 strains of Enterococcus isolated from various clinical specimens of two hospital of third grade class from 2008 to 2009 in Wuxi area were retrospectively analyzed. Results Among 170 strains of Enterococcus,the most organism was E. faecium （52.9%） ,the second was E. faecalis （41.2% ）. The main localities from where the Enterococcus isolated were urinary tract （77.0%）, then bile tract （6.0%） and blood origin （4.0%）. Drug susceptibility test results showed that Enterococcus strains were resistant to many antibiotics ,but almost of all were extremely sensitive to vancomycin and linezolid. The resis- tance rates of E. faecium to Quinupristin/Dalfopristin,tetracycline and chloramphenicol were significantly lower than that of E. faecalis,but contrary to other antibiotics. There was significant difference between two groups （P〈0.05）. The rates of six multi-drug resistance and eight multi-drug resistance of E. faecium were obviously higher than those of E. faecalis. Conclusion The most common Enterococcus causing hospital infections in Wuxi area are E. faecalis and E. faecium. The resistance rates of E. faecium to many antibiotics are higher than that of E. faecalis. The antibiotics should be reasonably applied according to antimicrobial susceptibility test during clinical therapy, and also chose linezolid to treat infections caused by vancomycin-resistant Enterococcus.