3年尿液标本肠球菌属的耐药性分析  

Drug Resistance of Enterococcus faecalis and Enterococcus faecium Isolated from Urine Specimen During Last 3 Years

作　　者：王伟平[1] 段达荣[1] 张仙森[1] 

机构地区：[1]温州医学院附属台州市第一人民医院检验科,浙江台州318020

出　　处：《中华医院感染学杂志》2010年第18期2872-2874,共3页Chinese Journal of Nosocomiology

摘　　要：目的了解近3年粪肠球菌和屎肠球菌在尿液标本中的检出及对常用抗菌药物的耐药性,指导临床合理用药。方法采用法国生物梅里埃公司全自动细菌鉴定系统VITEK 32型和VITEK compact进行菌株鉴定,采用GPS-110和GP535药敏卡测定其对11种抗菌药物的敏感性。结果自2007年1月-2009年12月尿液标本共检出粪肠球菌76株、屎肠球菌50株;屎肠球菌对莫西沙星、左氧氟沙星、链霉素、高浓度庆大霉素、呋喃妥因和青霉素G的耐药率,分别为90.0%、90.0%、62.0%、92.0%、60.0%和92.0%,均较粪肠球菌(43.4%、52.6%、44.7%、36.8%、6.6%和30.3%)高,差异有统计学意义(P<0.05);对四环素的耐药率(30.0%)较肠球菌(60.5%)为低,差异有统计学意义(P<0.05);两种肠球菌对万古霉素、替考拉宁、利奈唑胺耐药率(0～8.0%)均较低;3年共检出1株耐万古霉素粪肠球菌和4株耐万古霉素屎肠球菌。结论粪肠球菌和屎肠球菌在尿液标本中的耐药性明显不同,在治疗其引起的感染时应按药敏试验结果用药;临床耐万古霉素肠球菌正日益增多,应引起重视。OBJECTIVE To explore the detection of Enterococcus faecalis and E.faecium isolated from urine specimen during the last 3 years and their drug resistance,to guide rational application of drugs in clinics.METHODS The bacteria specimen were identified with biomerieux bacteria identification system VITEK 32 and VITEK compact of France.The sensitivities to 11 antibacterials were determined with sensitivity test card GPS-110 and GP535.RESULTS A total of 76 strains of E.faecalis and 50 strains of E.faecium were isolated from urine specimen from Jan 2007 to Dec 2009.The result showed that all the drug resistant rates of E.faecium to moxifloxacin,levofloxacin,streptomycin,high level gentamicin,nitrofurantoin and penicillin G were 90.0%,90.0%,62.0%,92.0%,60.0% and 92.0%,respectively,which were higher than those of E.faecalis（43.4%,52.6%,44.7%,36.8%,6.6%and30.3%,respectively（P0.05）;but the drug resistance rate to tetracycline（30.0%） was lower than that of E.faecalis（60.5%）（P0.05）;and both of the drug resistance rates of the two enterococci to vancomycin,teicoplanin and linezolid were low（0-8.0%）.one strain of vancomycin-resistant E.faecalis and 4 strains of vancomycin-resistant E.faecium were detected in 3 years.CONCLUSION There is an obvious difference between the drug resistance of E.faecalis and E.faecium isolated from urine specimen.The infections caused by the two enterococci should be treated according to the drug sensitivity tests.The number of vancomycin-resistant enterococci is increasing,which is worthy of the notice.

关 键 词：粪肠球菌 屎肠球菌 耐药性 医院感染 

分 类 号：R378.1[医药卫生—病原生物学]