肠球菌属细菌医院感染的临床及耐药性分析  

Clinical characteristics and resistance analysis of enterococcus nosocomial infection

作　　者：王丽春[1] 李大江[1] 滕芳菊[1] 吕晓菊[1] 雷秉钧[1] 

机构地区：[1]四川大学华西医院感染性疾病中心,成都610041

出　　处：《中国抗生素杂志》2005年第4期238-240,共3页Chinese Journal of Antibiotics

摘　　要：目的探讨肠球菌属细菌所致医院感染的危险因素、临床特点及耐药情况,为临床治疗肠球菌感染提供指导。方法收集确诊为肠球菌医院感染病例的临床资料,分析发病的危险因素及临床特点,对分离到的菌株进行药物敏感性测定。结果49例肠球菌医院感染患者均存在着严重的基础疾病,69.39%的患者接受过侵袭性操作,感染部位以肺部最多见。分离出52株肠球菌,包括粪肠球菌40株、屎肠球菌9株和其他肠球菌3株。肠球菌属对红霉素、喹诺酮类抗菌药物和利福平普遍耐药,而屎肠球菌对抗菌药物的耐药性普遍高于粪肠球菌,尤其对氨苄西林和青霉素G的耐药率明显高于粪肠球菌(P<0.01),未发现对万古霉素耐药的菌株。结论肠球菌属细菌医院感染常发生在免疫功能低下、有严重基础疾病、使用过侵袭性操作的患者,肺部感染最常见。肠球菌对常用抗菌药物耐药率较高,屎肠球菌的耐药性明显高于粪肠球菌,万古霉素敏感性高,是治疗肠球菌感染的最佳选择。Objective To investigate risk factor, clinical characteristics and resistance of enterococcus nosocomial infection and indicate the treatment of them. Methods The definitive strains of enterococcus were colleted; the risk factor and clinical characteristics were analyzed; and the sensitivity of isoltes against antibacterial agents were determined. Result Serious basal diseases exist among 49 cases of enterococcus nosocomial infections; and 69.39% of patients received invasive operations. Lower respiratory tract (e.g. lung) was the most common infected site; 52 strains of enterococci were isolated including 40 Enterococcus faecalis , 9 E.faecium , and 3 other species of enterococci. They showed general resistant to erythromycin, fluoroquinolones and rifampin. The resistant rate of E.aecium was higher than that of E.faecalis , especially to ampicillin and penicillin ( P <0.01). No stains resistant to vancomycin were found. Conclusion Enterococcus nosocomial infection usually occurred in the population of patients with lower immunity, serious basal diseases and invasive operations. Lower respiratory tract was the most common infective site. Enterococcus has high resistance to frequently used antibacterial agents. The resistant rates of E.faecium were higher than those of E.faecalis . Vancomycin is the best choice to treat enterococci nosocomial infections.

关 键 词：肠球菌 医院感染 耐药性 

分 类 号：R378.1[医药卫生—病原生物学]