临床感染肠球菌耐药性等的变迁

Study on the changes of epidemiology and antibiotic resistance of Enterococci

目的 对临床分离的肠球菌流行、抗菌药物的耐药与感染性疾病的关系以及变化趋势进行调查和分析。方法 对多年来分离的 60 7株肠球菌 ,用微生物自动分析系统 (AMS)进行鉴定和药物敏感实验 ,并进行综合分析。菌种用半固体营养琼脂 4℃保存 ,复测结果和原测结果 10 0 %吻合。结果 两个时期临床分离的肠球菌都以粪肠球菌、屎肠球菌为主 ,其次为鸟肠球菌和鸡肠球菌 ,但屎肠球菌所占比例有所增加。分离部位 1995～ 1997年脓液标本占首位 ,1999～ 2 0 0 1年痰标本占首位。两个时期药物敏感实验结果显示对所测 9种抗菌药物的耐药率普遍上升 ,对青霉素、氨苄西林、高浓度庆大霉素、高浓度链霉素、四环素的耐药率有统计学差异 ,两个时期都没有发现耐万古霉素的肠球菌 ,两个时期屎肠球菌的耐药率均高于粪肠球菌。结论 由屎肠球菌引起的肠球菌感染在增加 ;由肠球菌引起的呼吸道系统感染在增加 ;肠球菌对各种抗菌药物的耐药率在上升 ;屎肠球菌的耐药严重 ;

Objective To investigate the epidemiology, antibiotic resistance tendency of Enterococci isolated from patients, and its relations with infectious disease. Methods The enterococci separated during 1995-1997 and 1999-2001 were identified with VITEK automicrobiology sytem(AMS) and susceptibility test. Then the data were analyzed. Results The Enterococcus species separated were mainly Ent. faecalis and Ent. faecium. Ent. avium and Ent. gallinarum were in the second order. The antibiotic resistance rate rised generally. There was significant difference in resistance rate to ampicillin, penicillin, tetracyline, gentamycine 500 and streptomycin 2000. No vancomycin resistance stains was found. The resistant rate of Ent. faecium was higer than that of Ent. faecalis. Conclusions Infectious disease caused by Ent. faecium is growing; Enterococci caused much more respiratory infection and was resistant to many antibiotics, especially in Ent. feacium; vancomycin was still effective drug for treating Enterococci infection.