粪肠球菌和屎肠球菌感染的临床特征及耐药性对比分析  

A comparative study on clinical characteristic and antibiotic resistance of E.faecalis and E.faecium

作　　者：孙艳美[1] 鞠晓红[1] 宿丽娟 李文彬[3] 

机构地区：[1]吉林医药学院检验学院,吉林132013 [2]吉林吉化集团总医院检验科,吉林132022 [3]吉林医药学院组织部,吉林132013

出　　处：《现代预防医学》2014年第1期125-127,共3页Modern Preventive Medicine

摘　　要：目的分析粪肠球菌和屎肠球菌感染的临床特征和耐药特点,为肠球菌感染的经验治疗提供依据。方法收集2006-2010年临床标本,常规分离培养细菌,K-B纸片法进行药物敏感性试验,SPSS11.0软件进行统计学分析。结果共分离细菌1 404株,其中粪肠球菌和屎肠球菌的分离率分别是5.48%(77株)和3.85%(54株)。粪肠球菌主要分布于痰液(44.16%)和伤口分泌物(31.17%),屎肠球菌主要分布在尿液(42.59%)和穿刺引流液中(24.07%),其差异具有统计学意义(P<0.05)。未发现万古霉素和替考拉宁耐药菌株,屎肠球菌对青霉素、阿莫西林、氨苄西林/舒巴坦、环丙沙星、左氧氟沙星、阿米卡星、复合磺胺、红霉素和高浓度庆大霉素的耐药率显著高于粪肠球菌(P<0.05);粪肠球菌对四环素和米诺环素的耐药率高于屎肠球菌(P<0.05)。结论粪肠球菌和屎肠球菌在感染部位和耐药性方面均存在差异,临床应加强细菌监测,根据药敏结果合理进行抗菌治疗,控制耐药菌株的流行。Objective To investigate the clinical distribution and drug resistance of E.faecalis and E.faecium for rational antimicro- bial therapy. Methods Bacteria were isolated and identified by conventional cuhure from 2006 to 2010, and drug resistance test was performed by K-B method. Data were analyzed using SPSS11.0 software. Results 1 404 strains of bacteria were isolated, in which the separated rate of E.faecalis and E.faecium was 5.48%（77 strains） and 3.85% （54 strains）respectively. The clinical distribution of E.faecalis mainly came from sputum （44.16%） and burn wound （31.17%）, but E.faecium mainly came from urine （42.59%） and drainage fluid（24.07%）.We didn＇t find resistance to vancomycin and teicoplanin against enterococcus. The drug resistant rates of E. faecium to nine antibiotics （penicillin, amoxicillin, ampicillin / sulbactam, ciprofloxacin, levofloxacin, amikacin, sulfamethoxazole, erythromycin and gentamicin ）were higher than that of E. faecalis （P〈0.05） and E. faecalis to two antibiotics （tetracycline and minocycline） were higher than that of E. faecium （P〈O.05）. Conclusion There are obvious differences in clinical distribution and drug resistance of E.faecalis and E.faecium. The clinician should reasonably choose antibiotics to avoid occurrence and prevalence of drug resistance bacteria.

关 键 词：肠球菌 临床分布 耐药 

分 类 号：R378.1[医药卫生—病原生物学]