肠球菌血流感染研究进展

Research advances in enterococcal bloodstream infection

近年来,随着肠球菌感染发生率的增加,有关肠球菌血流感染、尿路感染和腹腔感染的研究也逐渐增多,其中肠球菌血流感染病死率显著增加,预后不佳。临床上肠球菌感染以屎肠球菌和粪肠球菌为主。年龄、性别、致病菌种类及耐药情况、治疗方案的选择等均与肠球菌血流感染的发生和预后密切相关。此外,耐万古霉素肠球菌血流感染的治疗用药——达托霉素和利奈唑胺血药浓度及剂量的选择也被广泛关注。遵守临床操作规程,合理选择抗生素的种类及剂量浓度,严格监测药物使用情况,可减少血流感染的发生率,改善预后。现对肠球菌血流感染的发生及预后危险因素、治疗药物的选择进行综述,以期为肠球菌血流感染患者的临床治疗提供指导。

In recent years,with the increasing incidence of enterococcal infection,the studies on enterococcal bloodstream infection,urinary tract infection and abdominal infection have also gradually increased.Enterococcal bloodstream infection significantly contributes to mortality and poor prognosis,which is mainly caused by Enterococcus faeciumand Enterococcus faecalis clinically.Age,sex,type and drug resistance of pathogenic bacteria,and treatment options are closely related to the occurrence and prognosis of enterococcal bloodstream infection.In addition,the serum concentration and dosage of daptomycin and linezolid for treatment of bloodstream infection caused by vancomycin-resistant enterococci have also attracted wide attention.Following the clinical procedures,selecting antibiotics with rational dose and concentration and monitoring drug use strictly can reduce the incidence of bloodstream infection and improve prognosis.We reviewed the risk factors for the occurrence and prognosis of enterococcal bloodstream infection and the selection of therapeutic drugs,with the purpose of providing guidance for clinical treatment.