摘要
目的回顾性分析本院连续3年肠球菌属的分布特征及抗菌药物的耐药情况,为临床治疗和控制该菌属引起的医院感染提供依据。方法选取2012年1月至2014年12月本院住院患者送检各类细菌培养标本,对优势菌或纯培养菌落采用DL-Medical细菌测定系统及配套STREP测试板进行细菌鉴定及药敏试验。结果肠球菌属引起临床各系统感染呈现逐年上升趋势,主要是粪肠球菌和屎肠球菌,连续3年本院共检出1637株,主要分布于老年病科、泌尿外科、ICtJ和妇科;在各类标本中尿液检出最多,其次为分泌物和痰液。药敏结果显示:粪肠球菌对青霉素、氨苄西林敏感性强,可作为临床治疗粪肠球菌引起感染的首选抗菌药物;四环素、红霉素耐药率高,呋喃妥因可作为治疗粪肠球菌引起泌尿系感染的首选。屎肠球菌对于青霉素、氨苄西林、红霉素、环丙沙星、左氧氟沙星和呋喃妥因耐药率高,均不适用临床经验用药;只有对氯霉素敏感性强,平均耐药率为14.9%。高水平庆大霉素耐药的粪肠球菌和屎肠球菌平均检出率分别为50.7%和60.8%。屎肠球菌的耐药率除四环素、氯霉素外均显著高于粪肠球菌,平均耐药率比较,差异具有统计学意义(P均<0.05)。未检出万古霉素、利奈唑胺耐药的粪肠球菌和屎肠球菌菌株。结论对于肠球菌属感染的治疗必须准确依据药物敏感试验和感染部位选用合适的抗菌药物,才能有效预防和控制肠球菌属感染,以减少耐药株产生及传播。
Objective To analyze the distribution and drug resistance of Enterococcus in our hospital for three consecutive years retrospectively,and to provide a basis for the control and treatment of nosocomial infections caused by Enterococcus.Methods Various samples of inpatients in our hospital from January 2012 to December 2014 were cultured,the pathogens identification and drug susceptibility test were performed by DL-Medical bacterium measurement system and supporting STREP test board.Results Various clinical infections caused by Enterococcus increased year by year,Enterococcus faecalis and Enterococcus faecium were main,637 strains of Enterococcus were mainly distributed in geriatrics,ICU,Urology and Gynecology Department,which were detected in our hospital for three consecutive years,which were mainly detected from the sample of urine,secondly form secretion and sputum.The drug resistance rates of Enterococcus showed that Enterococcus faecalis were high drug susceptibility to penicillin and ampicillin,which could be used as the first choice of treatment for infections caused by Enterococcus.The drug resistance rates of tetracycline and erythromycin were high.Nitrofurantoin could be used as the first choice of treatment for urinary tract infections caused by Enterococcus.The drug resistance rates of Enterococcus faecium to penicillin,ampicillin,erythromycin,ciprofloxacin,levofloxacin and nitrofurantoin were high,which were not applicable for clinical use of experience.The drug susceptibility of Chloromycetin was high（14.9%）.The average drug resistance rates of Enterococcus faecalis and Enterococcus faecium to high levels of gentamicin were 50.7%and 60.8%.The drug resistance rates of Enterococcus faecium were significantly higher than that of Enterococcus faecalis except tetracycline and chloramphenicol.No vancomycin and linezolid resistant strains were detected.Conclusions Clinicians should choose antimicrobial agents rationally according to drug susceptibility results and infection site of Enterococcus in order to effectively prevent and control Enterococcus infections and reduce the generation of resistant strains.
出处
《中华实验和临床感染病杂志（电子版）》
CAS
2015年第6期77-80,共4页
Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)
基金
辽宁省自然科学基金(No.2014020124)
关键词
肠球菌
医院感染
病原菌
耐药性
Enterococcus
Nosocomial infections
Pathogen
Drug resistance
