临床感染常见肠球菌的耐药现状分析  

Analysis on antimicrobial resistance of commonly isolated Enterococcus in clinical infection

作　　者：付启云[1] 韩其香[1] 郑绍同[1] 孙海平[1] 唐朝贵[1] 

机构地区：[1]南京医科大学附属淮安第一人民医院,江苏淮安223300

出　　处：《中国感染控制杂志》2008年第5期342-344,共3页Chinese Journal of Infection Control

摘　　要：目的了解引起临床感染的常见肠球菌耐药现状,为临床抗肠球菌感染提供选药依据。方法采用VITEK-32全自动细菌鉴定药敏仪及配套鉴定、药敏板监测172株粪肠球菌和68株屎肠球菌对常用抗菌药物的耐药率。补充药敏试验采用K-B纸片扩散法。结果粪肠球菌对青毒素、氨苄西林的耐药率分别为23.26%和19.76%,而屎肠球菌对上述两药的耐药率分别为85.62%和90.83%;粪肠球菌对利福平、呋喃妥因、左氧氟沙星的耐药率分别为32.33%、18.98%、39.05%,而屎肠球菌对上述药的耐药率分别为84.63%、35.29%、75.00%;经统计分析,粪肠球菌与屎肠球菌的耐药率差异有显著性(P<0.01)。粪肠球菌对高浓度庆大霉素(500mg/L)、链霉素(2000mg/L)的耐药率分别是54.85%、51.74%,而屎肠球菌却为71.16%、70.15%;发现1株粪肠球菌对万古霉素耐药。结论屎肠球菌对临床常用抗菌药物的耐药率高于粪肠球菌,应根据肠球菌的种类和药敏试验结果确定用药方案;警惕耐万古霉素肠球菌的出现,动态监测肠球菌的耐药状况对指导临床治疗具有重要意义。Objective To evaluate antimicrobial resistance of Enterococcus in clinical infection, so as to provide guidance for clinical treatment. Methods VITEK-32 automatic system was used to identify antimicrobial resistance of 172 strains of Enterococcus faecalis （E. faecalis） and 68 Enterococcus faeciurn （E. faecium）, Kirby Bauer method was used as supplement test. Results The resistant rate of E. faecalis to penicillin and ampicillin was 23. 26% and 19.76% respectively, while E. faeciurn was 85. 62% and 90.83% respectively; the resistant rate of E. faecalis to rifampicin, nitrofurantoin and ievofloxacin was 32. 33%, 18. 98% and 39. 05% respectively, while E. faecium was 85.62%, 35.29% and 75.00% respectively, statistical analysis showed that the difference in antimicrobial resistant rate between E. faecalis and E. faecium was significant （P〈0. 01 ）. Resistant rate of E. faecalis to high concentration gentamycin （500 mg/L） and streptomycin （2 000 mg/L） was 54. 85% and 51.74% respec tively, and E. faecium was 71.16% and 70. 15% respectively; one strain of E. faecalis was resistant to vancomy cin. Conclusion The resistance of E. faeciurn to commonly used antimicrobial agents is higher than that of E. fae calls, the choice of antimicrobial agents should be according to the species of Enterococcus and antimicrobial susceptibility test results, the resistance of Enterococcus to vancomycin should cause clinical attention, continual surveillance of resistance of Enterococcus is important to direct the treatment of Enterococcus infections.

关 键 词：肠球菌 抗药性 微生物 抗菌药物 合理用药 

分 类 号：R378.1[医药卫生—病原生物学]