住院患者下呼吸道肠球菌属感染及耐药分析

Antibiotic Resistance and Enterococcal Infections among Inpatients with Lower Respiratory Infection

目的 调查我院住院患者下呼吸道肠球菌感染及其耐药。方法 回顾性分析 2 0 0 0年 10月～ 2 0 0 2年 11月分离出肠球菌属住院患者的临床资料和耐药情况。结果 我院痰标本共分离肠球菌属病、侵入性操作和长期持续使用抗生素可能是肠球菌感染的危险因素 ;药敏结果显示 ,氨苄西林和青霉素对粪肠球菌敏感性为 83.3%和 77.8% ,屎肠球菌耐药率高于粪肠球菌 ,二者对万古霉素的敏感性为 10 0 % ,高水平耐氨基糖苷类肠球菌(HL AR)分离率为 80 .2 %。结论 下呼吸道肠球菌感染的发生率增加 ,万古霉素抗菌活性最强 ,合理及时治疗是关键。

OBJECTIVE To investigate the prevalence of enterococcal infection and the susceptibility of Enterococcus to antibacterial agents in hospitalized patients of our hospital. METHODS Retrospective study of the clinical materials of 101 cases with lower respiratory tract infection caused by Enterococcus in hospital,bacterial susceptibility was analyzed. RESULTS A total of 101 Enterococcus strains were isolated from sputum,14 cases from respiratory ward and 19 cases from RICU. Ages, prolonged hospitalization,severe underlying diseases,invasive operation and application of multiple antibiotics might be the risk factors of Enterococcus infection. Ampicillin and penicillin were susceptible against E. faecalis ,inhibition rates being 83.3% and 77.8%,respectively. Strains of E.faecium were more resistant than that of E. faecalis . Vancomycin was the most active agent against enterococcal isolates. In 101 isolated strains 81 were high level aminoglycoside-resistant (HLAR). CONCLUSIONS The prevalence of enterococcal infection in lower respiratory tract is increased. Vancomycin has the best antibacterial activity against Enterococcus . Early diagnosis and rational treatment are the key to cure these patients.