老年患者肠球菌属感染的临床分布及耐药性分析

Clinical distribution of Enterococcusinfections in elderly patients and analysis of drug resistance

目的了解医院老年患者肠球菌属感染的临床分布特点及耐药性。方法使用法国生物梅里埃公司VITEK-32型全自动微生物分析仪及配套的GPI鉴定卡进行鉴定,并用K-B法进行抗菌药物敏感试验;数据处理应用WHONET5.4软件分析。结果临床老年患者感染的136例肠球菌属中粪肠球菌67株,占49.3%,屎肠球菌52株,占38.2%,主要发生在老年病科、ICU、肾内科和呼吸科,标本类型中尿液66株占44.1%,其次是痰液47株占34.5%;粪肠球菌对抗菌药物耐药性比屎肠球菌低,但粪肠球菌对四环素的耐药性却高于屎肠球菌,未发现耐万古霉素和替考拉宁的肠球菌属。结论肠球菌属对抗菌药物的耐药性不同,临床抗感染治疗应根据本地区分离菌株的体外抗菌药物敏感性试验结果为依据,选择敏感抗菌药物对其感染进行治疗。

OBJECTIVE To understand the clinical distribution and drug resistance of Enterococcus causing infections in elderly patients.METHODS By the means VITEK-32 type automatic microbial analyzer of French company BioMerieux and supporting GPI identification card,the identification of the strains was performed,and the antibiotic susceptibility testing was carried out using K-B method;the data processing was performed with WHONET5.4 software.RESULTS Of 136 strains of Enterococcus causing infections in elerly patients,there were 67（49.3%）strains of Enterococcus faecalis and 52（38.2%） strains of Enterococcus feces,those isolates mainly distributed in department of geriatrics,ICU,department of nephrology,and department of respiratory medicine;of the various specimen sources,66（44.1%） strains were isolated from urine,47（34.5%） strains were isolated from the sputum;the drug resistance of E.faecalis was lower than that of E.feces,but the resistance of E.faecalis to tetracycline was higher than that of E.feces,no strains of vancomycin or teicoplanin-resistant Enterococci were found.CONCLUSION Enterococci vary in drug resistance,it is necessary to choose the susceptible antibiotics for the clinical anti-infection treatment on the basis of the in vitro antibiotics susceptibility testing for the isolated strains from the local region.