肠球菌属的临床分布特点及多重耐药性分析

Analysis on clinical distribution characteristic and multi-drug resistance of enterococcus

目的分析肠球菌属的分布特点及多重耐药性，为临床控制和预防多重耐药菌感染提供有效依据。方法采用法国生物梅里埃ATB自动鉴定仪进行病原菌鉴定和药敏试验，并对其分布特点及药敏结果进行统计分析。结果142株肠球菌属中以粪肠球茵为主，102株（71．8％），屎肠球菌次之，36株（25．4％）;标本来源以尿液为主，64株（45．1％），其次为胆汁，27株（19．0％）;＇主要分布在。肾内科，38株（26．8％），其次为泌尿烧伤科，34株（23．9％）;未检出耐万古霉素和替考拉宁菌株；屎肠球菌对喹奴普汀／达福普汀、氯霉素、四环素的耐药率（8．3％-19．4嘲明显低于粪肠球菌（32．4％-91．2％），对高浓度氨基糖苷类和其它多数抗生素的耐药率（38．9％-91．7％）明显高于粪肠球菌（11．8％-65．7％），差异有显著性（P〈0．05）。结论肠球菌种间耐药差异明显，屎肠球菌多重耐药程度高于粪肠球菌，因此临床分离的肠球菌应准确鉴定到种，才能更好地指导临床合理选用抗菌药物。

Objective To provide an effective basis for clinical control and prevention of multi-drug-resistant bacterial infections by analyzing the distribution features and multi-drug-resistant of enterococcus. Methods The French Merieux ATB Expression Automated Analysis System was used for bacterial identification and antimricrobial susceptibility test, distribution characteristics and antimicrobial susceptibility results were statistically analyzed.Results The main strains of 142 enterococcus was enterococcus faecalis 102（71.8%） , the second was E.faecium 36（25.4%）. Specimen source were found mainly from urine 64（45.1%）,then bile 27（19.0%）, and was mainly distributed in the Nephrology unit 38 （26.8%）, the second as Urologic Surgery 34（23.9%）. There was no drug-resistance had been spotted for Enterococcus to Vancomycin and Teicoplanin. The resistance rates of E.faecium to Quinupristin/Dalfopristin, Chloramphenieol and Tetracycline were significantly lower than those of E.faecalis, but contrary to high concentrations aminoglycosides of and most of other antibiotics. There was statistical significant difference between the two srtains （P〈 0.05）.Conclusions The drug-resistance of strains of enterococcus differed greatly.The multiple drug-resistant rate of E.faecium strains to most common drugs test is higher than that of E.faecalis. In order to better conduct clinical therapy of choosing antibiotic reasonably, we should be identified to the species of Enterococcus.