氨基糖苷类高水平耐药肠球菌医院感染分布特征及耐药性分析  

Distribution and Drug Resistance of High-level Aminoglycoside Resistance in Enterococcus spp in Hospital Infection

作　　者：李红玉[1] 李国成[1] 伍锡泉[1] 

机构地区：[1]中山大学附属第二医院,广州市510120

出　　处：《中国药房》2008年第35期2742-2744,共3页China Pharmacy

基　　金：广州市科学技术局重点攻关项目(2006Z1-E0141)

摘　　要：目的:了解氨基糖苷类高水平耐药肠球菌(HLAR)在医院感染中分布特征及耐药现状。方法:常规方法对我院2004～2007年住院患者的各种临床标本进行培养分离,采用全自动微生物鉴定仪对细菌进行鉴定及药敏检测。结果:292株引起医院感染的HLAR中,以粪肠球菌49.3%(144/292)及屎肠球菌41.4%(121/292)为主,分布主要在重症监护室占27.4%(80/292),其次肾内科及神经外科分别为17.5%(51/292)、8.9%(26/292),感染以泌尿系统感染为主占29.8%(87/292)。屎肠球菌对喹诺酮类及β-内酰胺类抗生素的耐药率明显高于粪肠球菌,但粪肠球菌对喹奴普汀/达福普汀的耐药率明显高于屎肠球菌(P<0.05),粪肠球菌及屎肠球菌对万古霉素、替考拉宁均敏感,对力奈唑烷耐药率分别为0.0%及4.1%(5/121)。结论:万古霉素、替考拉宁及力奈唑烷是当前治疗HLAR感染较好的抗菌药物。OBJECTIVE： To investigate the distribution and drug resistance of Highlevel Aminoglycoside Resistance Enterococcus spp （HLAR） in hospital infection. METHODS： The clinical specimens collected from 2004 to 2007 in our hospital were isolated by routine method. Identification of the bacteria and Antimicrobial susceptibility test were performed using automatic microbiology analysis system. RESULTS： Of the total 292 strains of Enterococcus which induced HLAR in hospital infection, Enterococeus faecalis （E.faecalis） represented 49.3% （144/ 292） and Enterococcus faecium （E.faecium） 41.4% （121/292）. 27.4% （80/292） were from intensive care unit, 17.5% （51/292） the department of nephrology and 8.9% （26/292） the neurosurgery department. The urinary system infection represented 29.8% （87/292） in hospital infection. The antimicrobial resistance of E. faecium was significantly higher than that of E. faecalis against quinolones and β- lactamase antibiotics, but the antimierobial resistance of E. faecalis was higher than that of E, faecium（P〈0.05） against Quinupristin/ Dalfopristin. Both E. faecalis and E.faecium were resistant to Vancomycin and Teicoplanin, and their antimicrobial resistance rates to Linezolid were 0.0% and 4.1% （5/121） respectively. CONCLUSION： Vancomycin, Teicoplanin and Linezolid were the best drugs for HLAR in hospital infection.

关 键 词：肠球菌 医院感染 耐药性 

分 类 号：R95[医药卫生—药学]