屎肠球菌和粪肠球菌临床分离株对利奈唑胺的耐药性分析

Research on the resistance of Enterococcus faecalis and Enterococcus faecium strains to linezolid

目的探讨耐利奈唑胺粪肠球菌和屎肠球菌常用抗菌药物的耐药性,为临床治疗提供参考。方法收集2011年1月-2015年12月临床分离的非重复粪肠球菌和屎肠球菌,采用自动化药敏检测法进行药敏试验,其中替考拉宁采用纸片扩散法,结果判断参照CLSI的解释标准。结果共分离出耐利奈唑胺粪肠球菌46例,耐药率为3.6%;耐利奈唑胺屎肠球菌23例,耐药率为1.8%。临床分离的2种耐利奈唑胺粪肠球菌对替加环素、万古霉素及替考拉宁高度敏感。耐利奈唑胺屎肠球菌对奎奴普丁-达福普汀较为敏感,耐药率为13.0%;对青霉素和氨苄西林耐药率则达到100.0%。而耐利奈唑胺粪肠球菌对呋喃妥因、青霉素及氨苄西林有较高的敏感性,耐药率分别为4.3%、10.9%及13.0%;对奎奴普丁-达福普汀的耐药率则达到100.0%。结论 2种耐利奈唑胺肠球菌对抗菌药物耐药谱存在差异,提示应加强药敏试验,合理选用抗菌药物。

Objective To explore the drug resistance of linezolid- resistant Enterococcus faecalis and Enterococcus faecium to commonly used antibiotics,so as to provide guidance for clinical treatment. Methods From January 2011 to December 2015,the clinical isolates of non- repetitive E. faecalis and E. Faecium were enrolled in the study,and then drug susceptibility testing was performed by using the automatic drug susceptibility test method,the drug susceptibility testing for teicoplanin was performed with the use of disk diffusion method,and the results were determined by referring to the criteria of CLSI. Results A total of 46 strains of E. faecalis were isolated,and the drug resistance rates was 3. 6%; 23 strains of E. faecium were isolated,and the drug resistance rates was 1. 8%. The strains were highly susceptible to tigecycline,vancomycin and teicoplanin. The linezolid- resistance E. faecium was susceptible to quinupristin- dalfoprisdn that the drug resistance rates was 13. 0%; and the drug resistance rates to penicillin G,ampicillin were 100. 0%. The linezolid- resistance E. faecalis was susceptible to nitrofurantoin,penicillin G and ampicillin,and the drug resistance rates were 4. 3%,10. 9% and 13. 0%,respectively; but the drug resistance rates to quinupristin- dalfoprisdn was 100. 0%. Conclusion There were differences between the resistance rate of the two linezolid- resistance Enterococcus to commonly used antibiotic,and we should strengthen the drug sensitivity test and rational use of antibiotics.