引起肠球菌感染上升的原因及其耐药性分析

Factors Resulting in Increasing Tendency of Infection Caused by Enterococcus and Their Resistance

目的 探讨引起肠球菌感染上升的原因 ,并对其耐药性进行分析。方法 采用回顾性调查 ,对我院 2 0 0 0～2 0 0 1年度 1918例呼吸道感染患者 ,在做痰培养前 1周内使用头孢菌素类和其他抗生素后 ,分离出肠球菌的情况和对 2 0 0 1年度肠球菌的耐药性进行分析。结果 2 0 0 1年度的 982例患者中使用头孢菌素类的 6 16例 ,分离出肠球菌 98例 ,分离率为 15 .9% ,36 6例使用其他抗生素的患者分离出肠球菌 16例 ,分离率为 4 .4 % ,二者差异有显著性 (P <0 .0 1) ,2 0 0 0年度的 936例患者中分离出肠球菌 4 6例 ,其中使用头孢菌素 (318例 )的患者中分离出肠球菌 36例 ,分离率为 11.3% ,在 2 0 0 1年度共分离出的 114株肠球菌中耐万古霉素 (VRE)的 4株 ,分离率为3 5 %。结论 由肠球菌所致的医院内呼吸道感染呈增高趋势 ,头孢菌素类抗生素的使用可能是原因之一 ,在治疗此类菌引起的感染时 ,应根据细菌培养结果合理选择抗生素 ,避免盲目使用对肠球菌无效的头孢菌素类。

OBJECTIVE To explore the factors resulting in increasing tendency of infection caused by Enterococcus, and to analyze their current resistance. METHODS A total of 1918 respiratory specimens of infected patients were collected from Jan 2000 to Dec 2001 in our hospital. The isolating status of the Enterococcus in all cases after treatment with cephalosporins or else antibiotics at least one week was analyzed retrospectively. On the other hand, the resistance of the Enterococcus acquired in 2001 was also analyzed. RESULTS Among 982 cases in 2001,98 strains of Enterococcus were isolated from 616 cases that had been treated with cephalosporins (15.9%), and 16 strains from other 366 cases(4.4%). There was significant difference between these two conditions (P<0.01). And among 936 cases in 2000, the isolating ratios of Enterococcus were 11.3% and 1.6%, respectively. There were 4 strains of vancomycin resistant Enterococcus (VRE) among all of the 114 strains of Enterococcus acquired in 2001 (3.5%). CONCLUSIONS The in hospital respiratory infection caused by Enterococcus showed an increasing tendency in recent years. The abusing of cephalosporins maybe an important factor. So, clinicians should select antibiotics rationally according to the susceptibility test, and should avoid using cephalosporins blindly.