摘要
目的了解医院感染肠球菌属的耐药性变迁和临床分布特点,为合理应用抗菌药物和预防控制医院感染提供依据。方法回顾性分析1999年1月-2011年12月临床标本中分离的1944株肠球菌属资料;用WHONET5.6软件分析耐药率变迁。结果临床分离的1944株肠球菌属中以屎肠球菌为主,1161株占59.72%,其次为粪肠球菌714株占36.73%;肠球菌属在各种临床标本中主要分离自尿液和血液,分别占37.65%、24.12%;肠球菌属在各临床科室的分布主要来自外科和内科,分别占31.79%和26.08%;粪肠球菌对多数测试药物的耐药率低于屎肠球菌,但对四环素的耐药率则相反;粪肠球菌对青霉素、氨苄西林的耐药率为19.66%和13.10%,对红霉素和四环素耐药率>70.00%,对高浓度庆大霉素的耐药率为35.49%;屎肠球菌对青霉素、氨苄西林、红霉素、利福平、环丙沙星及高浓度庆大霉素的耐药率均>70.00%;肠球菌属对万古霉素、替考拉宁和利奈唑胺保持很好的敏感性。结论肠球菌属感染以屎肠球菌和粪肠球菌为主,所引起的感染以泌尿系统感染和血流感染为主,肠球菌属总体耐药率较高,多药耐药和高耐药现象相当严重,屎肠球菌耐药性高于粪肠球菌,临床治疗时应根据耐药特点及菌种间的耐药性差异来选择相应的治疗方案,目前万古霉素、替考拉宁和利奈唑胺仍然是治疗肠球菌属感染的最佳药物。
OBJECTIVE To understand the clinical distribution and drug resistance of Enterococci causing nosocomial infections so as to provide guidance for the reasonable use of antibiotics and the prevention of nosocomial infections. METHODS The data of 1944 strains of Enterococci isolated from clinical specimens from Jan 1999 to Dec 2011 were retrospectively analyzed, and the change of drug resistance rate was analyzed with the use of WHONET 5.6 software. RESULTS Of totally 1944 clinical isolates of Enterococci, there were 1161 （59.72%） strains of Enterococcus faecium and 714（36.73%） strains of Enterococcus faecalis, Among 1944 isolates of Enterococci, 37.65% were isolated from urine specimens , and 24.12% from blood specimens; 31.79% of the Enterococci isolates were isolated from the surgery departments, 26. 08% were isolated from the adult internal medicine department. The drug resistance rates of the E. faecalis strains to the most tested drugs were lower than those of the E. faecium strains, however the drug resistance rate of the E. faecalis strains to tetracycline was higher than that of the E. faecium strains; the drug resistance rate of E. faecalis to penicillin was 19.66%, ampicillin 13.10%; the drug resistance rates to erythromycin and gentamicin were more than 70.00%;the drug resistance rate to high concentration of gentamicin was 35. 49%; the drug resistance rates of the E. faecium strains to penicillin, ampicillin, erythromycin, rifampicin, ciprofloxacin and high concentration of gentamicin were more than 70. 00%; Enterococci remained high susceptibility to vancomycin, teicoplanin, and linezolid.CONCLUSION The E. faecium and E. faecalis are the predominant species of Enterococci causing the urinary tract infections and the bloodstream infections; the Enterococci are highly drug resistant, the multidrug-resistance is fairly serious, and the drug resistance rate of the E. faecium is higher than that of the E. faecalis. It is necessary to choose corresponding treatment regimens based on the characteristics of drug resistance and the difference in drug resistance between the species; vancomycin, teicoplanin, and linezolid remain the optimal antibiotics for the treatment of Enterococci infections.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2013年第21期5313-5315,共3页
Chinese Journal of Nosocomiology
基金
辽宁省自然科学基金项目(201102265)
关键词
肠球菌属
抗菌药物
耐药性
临床分布
Enterococci
Antibiotic
Drug resistance
Clinical distribution
