肠球菌感染的临床调查

Clinical survey of enterococcal infections

目的 :了解肠球菌所致感染的概况及其对抗菌药的敏感性。方法 :调查与分析复旦大学附属华山医院 1998年 6月～1999年 3月临床分离获肠球菌住院患者的临床资料 ,用KB法测定细菌药敏。结果 :116例患者中 ,属医院感染、院外感染者分别为 37和 13例 ,带菌者 6 6例 ,感染部位多为尿路 (6 4% )、次为腹腔 (18% ) ,粪肠球菌 (6 4% )多于屎肠球菌 (36 % )。患严重基础疾病、接受介入诊疗操作、应用广谱抗菌药可能是肠球菌医院感染的危险因素。药敏结果显示 :氨苄西林、万古霉素对肠球菌抗菌活性相对较高 ,抑菌率分别为 75 .8%和 96 .9% ,屎肠球菌耐药率高于粪肠球菌。结论 :肠球菌已成为医院感染患者主要病原菌之一 ,及时、合理诊治是治愈该类感染的关键。

Objective:To investigate the prevalence of enterococcal infection and the susceptibility of Enterococcus spp.to antibacterial agents. Methods:The medical history of 116 hospitalized patients from whom Enterococcus spp were isolated during the period of June 1998-March 1999 were reviewed. Bacterical susceptibility testing were done by Kirby-Bauer method. Results: Out of 116 patients, 50 were patients with enterococcal infections, (nosocomial infection in 37, community infection in 13,) and 66 were carriers. The most common sites of infection were urinary tract (64%), abdominal cavity(18%) being the second. Among Enterococcus spp, E. faecalis accounted for 64%, E. faecium 36%. Severe underlying diseases, accepting intervention procedures and use of broad spectrum antibiotics were common risk factors. Vancomycin and ampicillin were the most active agents against enterococcal isolates, inhibition rates being 96.9% and 75.8% respectively. Strains of E. faecium were more resistant than strains of E. faecalis . Conclusions: Enterococcus spp. become one of the major pathogens in nosocomial infections. Early diagnosis and rational treatment is the key to improve the outcome of these patients.