243株肠球菌属临床分离株分布及抗菌药物敏感性分析  

Distribution and antibiotics sensitivity status of 243 strains of enterococcus from clinical samples

作　　者：钱扬会[1] 郭建巍[1] 马骢[1] 郝秀红[1] 刘丽娟[1] 李艳君[1] 马学斌[1] 

机构地区：[1]海军总医院检验科,北京100037

出　　处：《中华医院感染学杂志》2011年第9期1892-1894,共3页Chinese Journal of Nosocomiology

摘　　要：目的统计与分析海军总医院2008-2010年分离的肠球菌属对抗菌药物敏感试验结果,了解肠球菌属在临床各病区的分布情况以及抗菌药物敏感性,从而为肠球菌属的合理用药提供科学依据。方法按常规方法进行肠球菌属的分离培养与鉴定;用VITEK-32细菌鉴定仪进行菌株的鉴定;用K-B法进行抗菌药物药物敏感性试验,Bio-Mic药敏分析仪进行药物敏感性测定;用Whonet5.4软件进行药敏结果的统计和分析。结果 2008-2010年海军总医院共分离出243株肠球菌属,其中屎肠球菌、粪肠球菌、铅黄肠球菌、鹑鸡肠球菌、鸟肠球菌、耐久肠球菌、海氏肠球菌分别占56.0%、28.8%、7.0%、4.1%、2.1%、1.6%、0.4%,分离率占前3位的标本类型依次为尿液、分泌物和血液,共206株,占84.8%;尿路感染中以粪肠球菌为主,其次是屎肠球菌和铅黄肠球菌,屎肠球菌和铅黄肠球菌耐药率更高;检出率占前3位的科室分别为ICU、泌尿外科和呼吸内科;屎肠球菌耐药性高于粪肠球菌,对屎肠球菌耐药率最高的前3位抗菌药物分别是氨苄西林、青霉素和红霉素,耐药率分别为100.0%、97.1%和93.4%;对粪肠球菌耐药率最高的前3位抗菌药物分别是红霉素、四环素和左氧氟沙星,耐药率分别是80.0%、42.9%和38.6%。结论海军总医院分离的肠球菌属以屎肠球菌为主,肠球菌属间耐药性存在较大差异,治疗时应根据耐药特点及耐药性差异选择相应的药物,目前万古霉素仍然是治疗肠球菌属感染的有效药物。OBJECTIVE To explore the distribution and antibiotic sensitivity of 243 strains Enterococcus from clinical samples in navy general hospital from 2008 to 2010,to offer evidence for drug resistant monitoring and clinical antibiotics usage.METHODS All clinical specimens were isolated and cultured conforms to Standard Operation.The bacteria were identified by using the automatic microorganism analyzer VITEK,and bacteria＇s drug susceptibility tests were performed using K-B methods and Bio-Mic drug sensitivity analyzer.All the results were analyzed by Whonet 5.4 soft ware.RESULTS Totally 243 strains of Enterococcus were isolated in navy general hospital form 2008 to 2010.Enterococcus faeciumand Enterococcus faecaliswith a high incidence rate of 56.0% and 28.8%.Enterococcus casselifavus,Enterococcus gallinarum,Enterococcus avium,Enterococcus duransand Enterococcus hiraewith the incidence rates of 7.0%,4.1%,2.1%,1.6% and 0.4% respectively.Urine,secretion and blood were the major samples accounted for 84.8%.E.faecaliswas the major pathogenic bacteria causing urinary tract infection and then E.faeciumand E.casselifavuswhich with high drug resistance rates.ICU,department of urinary surgery and department of Respiratory Medicine were main award sickroom of Enterococcus infection.Drug resistances of E.faeciumwere higher than E.faecalis.The top three resistance antibiotics against E.faeciumwere ampicillin,penicillin and erythromycin and with a resistance rate of 100.0%,97.1% and 93.4%.for E.faecalis,erythromycin,tetracycline and levofloxacin were major resistance antibiotics with a resistance rate of 80.0%,42.9 % and 38.6% respectively.CONCLUSION Most of Enterococcus infection is due to E.faeciumand there are a lot of differences for drug resistance in the strains of Enterococcus.The hospital administers should strengthen the management of antibiotics usage,it is necessary to rationally use antibacterial agents on the basis of the drug resistance,infection sites and grade of infection.At present,vancomycin is the active drug

关 键 词：肠球菌属 耐药性 抗菌药物 

分 类 号：R378[医药卫生—病原生物学]