住院肾病患者尿路感染肠球菌的菌型分布及耐药性分析

Distribution and drug resistance of enterococcus in patients with urinary tract infection in nephrology department

目的分析住院肾病患者尿路感染肠球菌的菌型及耐药情况。方法选取2018年5月-2021年5月于本院收治的肾病患者346例。采集患者尿液标本,采用全自动微生物鉴定仪检测感染肠球菌的菌型;采用纸片扩散法(K-B法)检测肠球菌的耐药性。结果346例肾病患者中106例(30.64%)发生肠球菌尿路感染,感染者年龄多数≥40岁,且住院时间≥15 d。106例发生尿路感染的患者共检出146株肠球菌,其中粪肠球菌76株(52.05%),屎肠球菌54株(36.98%)。粪肠球菌对万古霉素、呋喃妥因的耐药率均低于10%,对红霉素、环丙沙星的耐药率均高于70%,屎肠球菌对万古霉素的耐药率为3.70%,对青霉素、红霉素、环丙沙星的耐药率均高于80%。结论住院肾病患者肠球菌尿路感染以粪肠球菌、屎肠球菌为主,屎肠球菌的总体耐药率高于粪肠球菌。

Objective To analyze the distributionand drug resistance of enterococcus in patients with urinary tract infection in nephrology department.Methods 346 patients with urinary tract infection treatedin the nephrologydepartment of our hospital from May 2018 to May 2021 were selected.The urine samples of patients were collected and the bacterial types were detected by automatic microbial identification instrumentand identified by comparative analysis with AES 8.01 database.The drug resistance was detected by disk diffusion method(K-B method),where the strain ATCC 29212 was used as quality control.Results Amongthe 346 nephrology patients,106(30.64%)patientshad enterococcal urinary tract infection.Most of theinfectedpatients were older than 40 years old and their hospital stay were longer than 15 days.146 strains of enterococcuswere detected in the106 patients,which included 76(52.05%)strains of Enterococcus faecalis,54(36.98%)strains of E.faecium,6(4.11%)strains of E.gallinarum,6(4.11%)strains of E.avium and 4(2.74%)strains of other kinds of enterococci.In the drug resistance test,the resistance rates of E.faecalis to vancomycin and nitrofurantoin were less than 10%,and the resistance rates to erythromycin and ciprofloxacin were higher than 70%.The resistance rate of E.faecium to vancomycin was 3.70%,and the drug resistance rates to penicillin,erythromycin and ciprofloxacin were higher than 80%.Conclusion Enterococcus in patients with urinary tract infection in nephrology department consists largely of E.faecalis and E.faecium,and the overall drug resistance rate of E.faecium is higher than that of E.faecalis.