烧伤患者肠球菌的耐药性分析及抗感染用药的探讨

Analysis on drug resistance of enterococci among burned patients and discussion of anti-infection drugs

目的了解烧伤住院患者肠球菌的分离情况并监测其对常用抗生素的耐药性，指导临床合理用药。方法对2009年1月至2012年12月烧伤住院患者临床标本中分离的168株肠球菌进行纸片扩散法药敏试验并进行分析。结果在168株肠球菌中，粪肠球菌117株，屎肠球菌46株，粪肠球菌和屎肠球菌占所分离肠球菌的97．O％。对高剂量氨基糖苷类的耐药率粪肠球菌在40．0％以上、屎肠球菌大于68．0％，对氨苄西林、青霉素的耐药率屎肠球菌明显高于粪肠球菌分别为52．3％、65．1％，未检出耐万古霉素的肠球菌。结论肠球菌对万古霉素敏感性最高，屎肠球菌的耐药性明显高于粪肠球菌，提示临床在治疗此类菌感染时要明确菌种，根据分离株的耐药特点和药敏试验结果合理选用抗生素。

Objective To understand the infection status and drug resistance of enterococci in burned patients to guided rational prescribing. Methods A total of 168 strains of enterococci, isolated from the samples of burned patients between January 2009 and December 2012, were detected for drug resistance by using K-B method. Results Among the tested enterococci, 117 strains were E. faecalis and 46 strains were E. faecium, both of which accounting for 97.0~ The resistance rate to HLGR of E. faecalis was over 40~ and of E. faecium was more than 68%, and to ampicillin and penicillin were 52.30/oo and 65.1~ respectively. Vancomycin resistant enterococci was not tested yet. Conclusion Enterococci might be most susceptible to vancomycin and the drug resistance of E. faecium could be obviously stronger than E. faecalis, which suggesting that the species should be identified, and the antibiotics should be selected according to the results of drug sensitive test.