住院患者医院感染肠球菌属的分布与耐药性分析

The distribution and drug resistance analysis of Enterococcus faecalis and Enterococcus faecium

目的：分析医院感染粪肠球菌与屎肠球菌的分布及其耐药性，为临床有针对性采取预防措施、合理用药提供可靠依据。方法对2010－2012年医院患者送检标本培养出的粪肠球菌、屎肠球菌采用的法国生物梅里埃公司的VITEK‐60全自动细菌鉴定分析仪进行鉴定，药物敏感试验采用 K‐B纸片扩散法，采用统计分析软件SPSS16．0进行数据统计分析。结果共培养出149株粪肠球菌和120株屎肠球菌，其中重症医学科较高分别占20．81％、30．83％；主要分布在＜10岁及50～80岁患者；肠球菌属在尿液、分泌物、脓液、血液、痰液、腹水、胆汁检出率较高；粪肠球菌对万古霉素、替考拉宁、利奈唑胺敏感率分别为100．00％、98．66％，对红霉素、四环素耐药率分别为77．85％、69．13％；屎肠球菌对万古霉素、替考拉宁、利奈唑胺敏感率分别为100．00％、100．00％、98．33％，对红霉素、青霉素G、氨苄西林等抗菌药物耐药性较高，分别为97．50％、96．67％、96．67％。结论不同科室、年龄、送检标本中肠球菌属分布不同，对不同抗菌药物敏感度不同，因此，应采取针对性措施，以降低肠球菌属感染发生率。

OBJECTIVE To analyze the distribution and drug resistance of Enterococcus f aecalis and Enterococcus f aecium in a three level of first‐class hospital so as to provide a reliable basis for rational use of drugs and preven‐tive measures in clinical .METHODS The distribution and drug resistance were measured by VITEK‐60 automatic bacteria analyzer produced by Biomerieux from 2010 to 2012 .The data obtained were analyzed by SPSS 16 .0 soft‐ware .RESULTS Totally 149 strains of E .f aecalis and 120 strains of E .f aecium were cultured in different depart‐ments .ICU was found to have the most bacteria ,accounting for 20 .81% and 30 .83% respectively .Patients were mainly under the age of 10 or between 50 and 80 years old .Enterococci were mainly in urine ,secretions ,fester , blood ,sputum ,ascites and bile .E .f aecalis was sensitive to vancomycin （100 .00% ） ,teicoplanin （98 .66% ） ,lin‐ezolid （99 .33% ） and resistant to erythromycin （77 .85% ） ,tetracycline （69 .13% ） ,ciprofloxacin （48 .32% ） ,rif‐ampicin （42 .28% ） and levofloxacin （41 .61% ） .E .f aecium was sensitive to vancomycin （100 .00% ） ,teicoplanin （100 .00% ） ,linezolid （98 .33% ） and resistant to erythromycin （97 .50% ） ,penicillin G （96 .67% ） ,ampicillin （96 .67% ） ,tetracycline （74 .17% ） ,ciprofloxacin （89 .17% ） ,levofloxacin （84 .17% ） and rifampicin （74 .17% ） . CONCLUSION Enterococcus distribution varies in different departments ,different ages anrd different specimens . E .f aecalis and E .f aecium have different sensitivity to different antibiotics .Therefore ,specific measures should be taken in departments and age phases with high detection rate .The specimen detection should be strengthened . The antibiotics should be chosen reasonably according to the drug sensitivity results .In this way the incidence in‐fection rate of E .f aecalis and E .f aecium will reduce correspondingly .