屎肠球菌及粪肠球菌临床感染的分析研究

Analysis of clinical infection of Enterococcus faecium and Enterococcus faecalis

目的分析屎肠球菌和粪肠球菌感染的临床分布及耐药敏性,为临床合理选择抗菌药物提供依据。方法采用美国布鲁克IVD MALDI Biotyper 2.3全自动微生物分析仪进行细菌分析鉴定菌种,同时采用英国产OXOID药敏纸片,用K-B法进行药敏实验。结果屎肠球菌泌尿外科占20.1%、肝胆外科14.4%、重症医学科11.4%;粪肠球菌泌尿外科26.5%,产科11.1%,普外科6.3%。屎肠球菌对青霉素、氨苄西林、左氧氟沙星的耐药率较高。粪肠球菌对米诺环素、利福平及左氧氟沙星的耐药率较高。它们对替考拉宁、万古霉素、利福平、利奈唑胺有较高的敏感性。结论屎肠球菌和粪肠球菌对多种抗菌素具有较高的耐药率,为控制肠球菌耐药菌株的产生,临床应严格按照抗生素合理使用原则,结合药敏检测结果安全合理选择抗菌药物,提高临床治疗效果。

Objective Our study aims to analyze the clinical departments distribution and drug sensitivity surveillance of Enterococcus faecium and Enterococcus faecalis infection in order to provide the basis for rational selection of antimicrobial agents. Methods The samples of the hospitalized patients from May 2015 to December 2016 were analyzed and identified by automatic microbial analyzer IVD MALDI bacteria Biotyper 2. 3（ Brook,USA） with results of 495 cases infected by Enterococcus faecium and Enterococcus faecalis followed by drug sensitivity test carried out with K-B method（ OXOID,British） in order to analysis resistance to different drugs of pathogens. Results Enterococcus faecium accounted for 20. 1% of urinary surgery,14. 4% of hepatobiliary surgery,11. 4% of severe medical department; Enterococcus faecalis accounted for 26. 5% of urinary surgery,obstetric 11. 1%,general surgery 6. 3%. Enterococcus faecium has a higher resistance rate to penicillin,ampicillin and levofloxacin,and Enterococcus faecalis has a higher resistance rate to minocycline,rifampicin and levofloxacin. They all have a higher sensitivity to teicoplanin,vancomycin,rifampicin and linezolid. Conclusions Drug resistance of Enterococcus faecalis and Enterococcus faecalis had higher rate and even more in the former than in the latter. The clinical should safely and reasonable select antibiotics strictly in accordance with the principle of rational use of antibiotics and drug susceptibility test in order to improve the clinical treatment effect with consequence of avoiding emergence of Enterococcus drug-resistant strains.