肠球菌属细菌感染耐药性分析

Drug resistance of Enterococcus

目的了解中国医科大学附属盛京医院肠球菌属细菌的临床分布及耐药情况,为指导临床制定合理有效治疗方案提供理论依据。方法收集2017年1月1日至2017年12月31日我院门诊、住院患者肠球菌属细菌病原学资料,回顾性分析其菌种分布、标本分布、科室来源及其耐药特征。结果共分离出466株肠球菌属细菌,其中粪肠球菌211株(45.28%)、屎肠球菌255株(54.72%)。肠球菌属细菌均以尿液标本为最主要的来源,其次为全血标本,并且来源于尿液标本的肠球菌属细菌对临床常用抗生素的耐药率普遍高于非尿液标本肠球菌属细菌耐药率。儿科为屎肠球菌最主要的分布科室,而粪肠球菌则主要分布于泌尿外科。耐药性方面,除四环素、利福平和喹努普汀/达福普汀外,屎肠球菌对受检的其余18种抗生素的耐药性均高于粪肠球菌,但对喹努普汀/达福普汀无耐药性,而粪肠球菌对此种抗生素的耐药率却为100.00%。二者对克林霉素的耐药率均为100.00%。共检出耐万古霉素肠球菌7株(1.50%),耐替考拉宁肠球菌6株(1.28%),未发现对替加环素、利奈唑胺耐药菌株。结论屎肠球菌在肠球菌属细菌中占主要地位,且耐药率方面明显高于粪肠球菌,耐糖肽类抗生素菌株的出现需引起临床的高度警惕,应进一步加强耐药菌株的监测,并对临床应用抗生素加以规范。

Objective To explore the distribution and drug resistance of Enterococcus strains in our hospital and provide reliable basis for clinical treatment.Methods The data of Enterococcus strains during Jan 1, 2017and Dec 31,2017were collected from our hospital.The clinical distribution and drug resistance were analyzed retrospectively.Results A total of 466strain of Enterococci were isolated,among which there were 211strains of Enterococcus faecalis (45.28%)and 255strains of Enterococcus faecium (54.72%). The main source of the Enterococcus strains were urine samples,foIlowed by blood samples.The resistance rates oE Enteococcus from urine samples were generally higher than those of the pathogens from non-urine samples.Pediatrics department was the main source of the E.faecium,while the urology department isolated more E.faecalis.With the exception of tetracycline,rifampicin and quinopudine/dafopentin,the E.faecium strains showed higher resistances to the rest 18antibiotics than E.faecalis;the resistance rates of E.faecium to quinopudine/dafopentin were 0.00%,while those of the E.faecalis were 100.00%.Both the two types of pathogens showed a resistance rate of 100.00%to clindamycin.No strains resistant to tigecycline and linezolid were found in this study.Conclusion E.faecium was dominant among the Enterococci, and its drug resistance rates were also signihcantly higher than the E.faecalis.Clinicians should attach great attention to the emergence of glycopetlde antibiotic resistant strains.Moreover,the monitoring of drug resisant strains should be luther strengthened and the clinical application of common antibiotics should be standardized.