医院内感染肠球菌药物敏感性的检测

Detection of antibacterial susceptibility of nosocomical Enterococci infection

目的 了解临床分离肠球菌对常用抗菌药物的耐药性 ,特别是对万古霉素耐药肠球菌 (VRE)和庆大霉素高水平耐药 (HL GR)肠球菌的耐药状况。方法 对 1993年 1月至 1999年 6月间自本院临床标本中分离到的 415株肠球菌 ,分别进行纸片扩散法药敏试验和 β-内酰胺酶测定。结果 415株肠球菌中 ,β-内酰胺酶的产酶株占 5 .1% ,VRE和 HL GR肠球菌分别占 1.9%和 41.2 %。对常用的 9种抗菌药物的耐药率以万古霉素最低为 1.9% ,其次为氨苄西林 /舒巴坦耐药率 12 .0 % ,氨苄西林 14.7%、亚胺培南 14.7%、哌拉西林18.6 % ;对其他抗菌药物耐药率均超过 5 0 %。尿肠球菌对抗菌药物的耐药率明显高于粪肠球菌 ,HL GR株耐药率明显高于低耐株 ,VRE对常用的抗菌药物均显示耐药。结论 肠球菌对常用的抗菌药物以万古霉素敏感性最高 ,对其它常用的抗菌药物显示有很强的耐药性。

Objective To study the resistance of clinical isolation in Enterococcus spp to antibacterial agents , especially in vancomycin resistant Enterococci (VRE) and high level gentamicin resistant (HLGR) Enterococci . Methods A total of 415 strains of Enterococci were isolated from clinical samples in our hospital during the period of January 1993 to June 1999. The susceptibility testing and β lactamase determination were done for each of the strains. Results β lactamase producing rate was 5.1% among 415 strains of Enterococci . The ratio of VRE and HLGR Enterococci to the total isolates were 1.9% and 41.2% respectively. The resistant rate of 415 strains of Enterococci aganinst vancomycin was 1.9%, amipicillin/sulbactam 12.0%, amipicillin 14.7%, imipenem 14.7%, piperacillin 18.6%, and more than 50% strains were resistance to other antibacterial drugs. Enterococcus faecium and HLGR Enterococci were more resistant to common antibacterial agents than Enterococcus faecalis and low level gentamicin resistant Enterococci respectively, VRE were resistant to all antibacterial agents which were detected. Conclusions Enterococci were most susceptible to vancomycin among the 9 antibacterial agents and has high rate of resistance to other antibacterial agents.