肠球菌的分布特点及药敏分析

Study on the distribution and the antibiotic sensitivity of enterococcus

目的 了解肠球菌的分布特点及其对常用抗生素的敏感性 ,为临床治疗提供依据。方法 应用MicroScanAutoScan 4微生物分析仪对 5 0株肠球菌进行鉴定和药敏试验 ,同时进行 β 内酰胺酶的检测。结果 5 0株肠球菌中 ,粪肠球菌占 92 .0 % ,酪黄肠球菌占 4.0 % ,屎肠球菌和空肠肠球菌各占2 .0 % ;在各种临床标本的分离率生殖道分泌物为 48.0 %、脓液及创口分泌物为 2 0 .0 %、痰液为 18.0 %、尿液为 10 .0 %。 46株粪肠球菌对万古霉素、呋喃妥因、氨苄青霉素、青霉素G的敏感率分别为 97.8%、97.8%、95 .7%和 91.3 % ,对环丙沙星、利福平、四环素和红霉素的敏感率较低。 5 0株肠球菌对庆大霉素和链霉素增效筛选试验的敏感率分别为 3 6.0 %和 42 .0 % ,同时对庆大霉素和链霉素增效筛选试验耐药的肠球菌占 5 0 %。未发现产 β 内酰胺酶菌株。 结论 临床分离到的肠球菌以粪肠球菌为主。肠球菌在生殖道分泌物的分离率最高。粪肠球菌对万古霉素和呋喃妥因最为敏感 ,其次为氨苄青霉素和青霉素G ,四环素和红霉素耐药严重。有 5 0 .0 %的肠球菌感染不能用青霉素或粘肽类与氨基糖苷类联合用药。

Objective To investigate the distribution and the sensitivity to common antibiotics of enterococcus as a guideline for the treatment of enterococcus infection.Methods MicroScan AutoScan 4 was used for identifing and testing the antibiotic sensitivity of 50 enterococci isolated from clinical samples.Furthermore,β lactamase was measured by nitrocefin paper method.Results The isolation rates of E.faecalis,E.faecium,E.casseliflavus and E.hirae were 92.0%、 4.0%、2.0% and 2.0% respectively among 50 enterococci.The most common site of isolation was genital tract(48.0%),then was surgical wound (20.0%).The sensitive rates of E.faecais to vancomycin,nitrofurantoin,ampicillin and penicillin G were 97.8%、97.8%、95.7% and 91.3% respectively.E.faecalis showed fairly low sensitivity to ciprofloxacin,rifampin,tetracyline and erythromycin.The sensitive rate of 50 enterococci to high level gentamicin and streptomycin accounted for 36.0% and 42.0%.50.0%.Enterococci showed resistance to high level gentamicin and streptomycin at the same time.There was no β lactamase be detected in 50 enterococci.Conclusion The main species isolated from clinical samples is E.faecalis,and the most common infection site is the genital tract.E.faecalis is highly sensitive to vancomycin and nitrofurantoin and high resistance to tetracyline and erythromycin.The combined therapy with penicillins or vancomycin plus an aminoglycoside can not be used in 50.0% enterococci infection.