2013-2015年医院感染粪肠球菌和屎肠球菌的调查分析

Investigation and analysis of Enterococcus faecalis and Enterococcus faecius causing nosocomial infections from 2013 to 2015

目的了解粪肠球菌和屎肠球菌临床分离情况,分析不同标本来源的细菌耐药性,为临床治疗相关感染提供依据。方法回顾性分析医院2013-2015年临床分离的422株粪肠球菌和362株屎肠球菌,对菌株进行细菌鉴定和药物敏感性检测,并进行数据分析。结果 2013-2015年医院不同标本分离的粪肠球菌和屎肠球菌分别为422株和362株,其中主要来源于尿液标本,检出的粪肠球菌和屎肠球菌分别占70.2%和64.7%;粪肠球菌科室来源主要为泌尿外科、普通外科和干部保健科分别占21.1%、17.1%和14.5%;屎肠球菌科室来源主要为ICU、儿科和普通外科分别占19.6%、16.6%和12.7%;粪肠球菌对氨苄西林、呋喃妥因、万古霉素、利奈唑胺和替加环素都保持着很高敏感性,敏感率分别为99.8%、96.7%、99.8%、91.5%和99.8%;屎肠球菌对喹奴普汀/达福普汀、万古霉素、利奈唑胺和替加环素的敏感性仍较好,敏感率分别为92.3.%、97.2%、95.0%和98.6%。结论粪肠球菌和屎肠球菌主要引起泌尿道感染,多来自于病情危重、免疫力低下、留置导尿管,腹腔手术操作以及老年患者;两者对万古霉素、利奈唑胺和替加环素的敏感性仍保持较好的敏感性;临床应根据具体药敏结果进行治疗。

OBJECTIVE To understand the status of isolation of clinical Enterococcus faecalis and Enterococcus fae- cius strains and analyze the drug resistance of the strains isolated from different specimens sources so as to provide guidance for clinical treatment of related infections. METHODS A total of 422 strains of E. faecalis and 362 strains of E. faecium that were isolated from 2013 to 2015 were retrospectively analyzed. The strains were identified, the drug susceptibility testing was performed, and the data were analyzed. RESULTS Totally 422 strains of E. faecalis and 362 strains of E. faecium were isolated from different specimens in 2013-2015;70. 2% of the E. faecalis strains were isolated from the urine specimens, and 64.7 % of the E. faecium strains were isolated from the urine specimens. Of the isolated E. faecalis strains, 21.1%were from the department of urology, 17.1% from the de- partment of general surgery, 14. 5% from the department of cadre health care. Of the isolated E. faecium strains, 19.6% were from the ICU, 16.6% from the department of pediatrics, 12.7% from the department of general sur- gery. The E. faecalis strains maintained high susceptibility to ampicillin, nitrofurantoin, vancomycin, linezolid, and tigecycline~ the drug susceptibility rates were 99.8%, 96.7%, 99.8%, 91.5%, and 99.8%, respectively. The E. faecium strains were highly susceptible to quinupristin-dalfopristin, vancomycin, linezolid, and tigecy- cline% the drug susceptibility rates were 92.3. %, 97.2%, 95.0%, and 98.6%, respectively. CONCLUSION The urinary tract infection is mainly caused by the E. faecalis and E. faecium, which are mainly isolated from the pa-tients who are critically ill, immunocompromised, and urinary catheter-indwelling, or old or the patients who re- ceive abdominal surgeries. Both species maintain high susceptibility to vancomycin, linezolid, and tigecycline. It is necessary for the hospital to treat the patients based on the results of the drug susceptibility testing.