屎肠球菌耐药特性及其对万古霉素MIC值的变迁  

Surveillance for variation of MICs to vancomycin and drug resistance of Enterococcus faecium

作　　者：周翠[1] 吕美艳[1] 徐琦煜[1] 李超[1] 刘媚娜[1] 周铁丽[1] 

机构地区：[1]温州医学院附属第一医院实验诊断中心,浙江温州325000

出　　处：《中华医院感染学杂志》2012年第5期1020-1022,共3页Chinese Journal of Nosocomiology

摘　　要：目的了解屎肠球菌的临床感染特点和耐药特性,监测屎肠球菌对万古霉素MIC值的变迁,为指导临床用药,控制感染提供依据。方法 VITEK-60型全自动微生物分析仪检测屎肠球菌对临床常用抗菌药物的敏感性,E-test法检测160株屎肠球菌对万古霉素的MIC值。结果 2005-2008年屎肠球菌对青霉素、左氧氟沙星和高浓度庆大霉素的耐药率均>50.0%,四环素的耐药率较低,历年均有万古霉素耐药菌株检出,4年间分离株对万古霉素MIC值均数分别为1.88、1.69、1.70、1.82μg/ml,结果变化不大,对其中一株耐万古霉素屎肠球菌进行基因型检测,证实为vanA型。结论屎肠球菌耐药情况严重,并有一定比例的万古霉素耐药菌株检出,但万古霉素敏感株历年的MIC值变化不明显。OBJECTIVE To review and analyze the characteristics of clinical infections and the drug resistance features of Enterococcus faecium（E.faecium）,to monitor the variation of the MICs to vancomycin for E.faecium,so as to provide reference for clinical therapy and infection control.METHODS The drug susceptibility of all E.faecium strains to common antibiotics was examined in VITEK 60 automicrobiology system,and the MICs of vancomycin for 160 strains of E.faecium were tested by E-test method.RESULTS From 2005 to 2008,the drug resistance rates of E.faecium to penicillin,levofloxacin and high concentration of gentamicin were all above 50.0%,and the drug resistance rate to tetracycline was lower.Vancomycin-resistant isolates were found in every year.The mean MICs to vancomycin during the 4 years were 1.88μg/ml,1.69μg/ml,1.70μg/ml,and 1.82μg/ml,respectively,which remained almost unchanged.The genetic testing was performed for one isolate of vancomycin-resistant E.faecium and it was demonstrated to be vanA.CONCLUSION The drug resistance of E.faecium is serious,some vancomycin-resistant strains have been detected,but the MICs of vancomycin remained almost unchanged from 2005 to 2008.

关 键 词：屎肠球菌 万古霉素 耐药性 最低抑菌浓度 

分 类 号：R978.1[医药卫生—药品]