屎肠球菌的临床分布与耐药性分析

Clinical distribution and drug resistance of Enterococcus faecium

目的了解医院屎肠球菌的临床分布和耐药情况,为临床抗感染的预防与治疗提供参考。方法回顾性分析1999年1月至2011年12月临床标本中分离的1 161株屎肠球菌;用WHONET 5.6软件分析耐药率变迁。结果临床分离的1 161株屎肠球菌,在同期分离的1 944株肠球菌属中占59.72%,主要分离自尿液和血液,分别占40.91%和26.87%;主要分离自外科病区、内科病区、ICU和儿科病区的菌株,分别占29.37%、25.15%、13.95%和13.53%;屎肠球菌对多种抗菌药物耐药,对万古霉素、替考拉宁和利奈唑胺的耐药率较低,分别为1.04%、0.94%和1.85%。结论屎肠球菌在临床的分离率逐年增加,已成为医院内感染的主要病原菌之一,其多药耐药和高耐药现象相当严重,目前万古霉素、替考拉宁和利奈唑胺仍然是治疗肠球菌属引起感染的有效药物。

Objective To investigate the clinical distribution and drug resistance of Enterococcus faecium in our hospital and provide references for prevention and treatment of infection. Methods The results of drug susceptibility and clinical distribution of 1 161 E. faecium strains from Jan 1999 to Dec 2011 in our hospital were analyzed retrospectively by WHONET 5.6 software. Results Among 1 161 isolated E. faecium strains, most were from u- rine（40.91% ）and blood（26.87% ）;Majority strains were isolated from surgical wards, medical wards and ICU wards. E. faecium was resistant to muhiple antibiotics, the rates of drug resistance to vancomycin, teicoplanin and linezolid were 1.04%, 0.94% and 1.85% respectively. Conclusion E. faecium had become one of the predom- inant pathogens in nosocominal infections. E. faecium shows a high drug resistance and pan-resistant strains are gradually increasing. Vancomycin, teicoplanin and linezolid are the effective drugs for treating against the infection caused by Enterococcus.