两种肠球菌致泌尿外科医院重症患者尿路感染的耐药性对比分析

Comparative analysis of two patients with severe drug resistance of urinary tractnosocomial infection in the department of urology of Enterococcus induced

目的研究粪肠球菌和屎肠球菌致该院重症患者尿路感染现状并对其耐药性进行对比分析,为临床合理选用抗菌药物提供依据。方法收集2011年1月至2014年12月重症患者尿路感染分离的172株肠球菌进行分析,用法国生物梅里埃ATB微生物鉴定仪鉴定肠球菌,采用纸片扩散法(K-B)进行药敏试验,利用Whonet 5.6软件分析处理试验数据。结果共分离肠球菌172株,其中粪肠球菌和屎肠球菌的分离率分别是68.0%(117株)和32.0%(55株);药敏试验表明2种肠球菌对利奈唑胺、万古霉素、替考拉宁、替加环素都较敏感(耐药率小于5.0%),除这4种药物外,对其余12种抗菌药物耐药性差异有统计学意义(P<0.05);共检出5株耐万古霉素肠球菌,其中3株粪肠球菌,2株屎肠球菌,耐利奈唑胺的粪肠球菌3株,屎肠球菌1株。结论从该院重症患者尿液标本中分离出的肠球菌多重耐药严重,2种肠球菌的耐药性存在菌种差异,临床应加强细菌监测,治疗肠球菌感染时首选利奈唑胺、万古霉素、替考拉宁、替加环素。

Objective Research of Enterococcus faecalis and Enterococcus faecium to our hospital in patients with severeurinary tract infection status and to compare the resistance,to provide a basis for clinical rational use of antimicrobial agents.MethodsFrom 2011January-2014 December in our hospital with severe urinary tract infections in patients with isolated 172 strains of Enterococcus were analyzed,with the French bioMerieux ATB microorganism identification instrument identification of Enterococcus,using the disc diffusion method（K-B）was used in drug sensitivity test,by using WHONET 5.6software test data analysis and processing.Results A total of 172 strains of Enterococcus,the separation of Enterococcus faecalis and Enterococcus faecium rates were 68.0%（117strains）and 32.0%（55strains）;drug sensitive test showed that two kinds of Enterococcus to Linezolid、vancomycin、Ti Koa Laing、tigecycline are more sensitive（resistance rate 5%）,in addition to these 4drugs,for the other 12 kinds of antimicrobial resistance has significant difference（P〈0.05）;there were 5strains of vancomycin resistant Enterococcus,the 3strains of Enterococcus faecalis,2strains of Enterococcus faecium,Nailinai temozolomide of 3strains of Enterococcus faecalis,Enterococcus faecium strain.Conclusion Multi drug resistant Enterococcus isolated from our hospital in patients with severe in urine samples of serious,there are two kinds of resistance strain differences in Enterococcus,we should strengthen the monitoring of clinical bacteria,Linezolid、vancomycin、Ti Koa Laing、tigecycline preferred treatment of Enterococcus infections.