老年患者尿路感染肠球菌属的耐药性分析  

Analysis on drug resistance of Enterococcusin elderly patients with urinary tract infections

作　　者：郭利明[1] 费锦萍[1] 薛聪平[1] 

机构地区：[1]宁波市第二医院肾内二科,浙江宁波315010

出　　处：《中华医院感染学杂志》2015年第12期2701-2703,共3页Chinese Journal of Nosocomiology

基　　金：浙江省卫生厅基金资助项目(ZW-2010A029)

摘　　要：目的探讨老年尿路感染患者中段尿粪肠球菌及屎肠球菌的耐药性,为指导临床用药以及分析肠球菌属耐药性提供依据。方法回顾性分析2011年7月-2013年7月老年患者送检的中段尿标本,共分离出粪肠球菌71株、屎肠球菌96株,药敏试验使用K-B纸片扩散法,采用WHONET 5.1软件对研究数据进行分析处理,分析肠球菌属的耐药性。结果肠球菌属检出率泌尿外科占33.53%、重症医学科占23.35%、内分泌科占15.57%;粪肠球菌对红霉素、四环素以及环丙沙星的耐药率最高,分别为87.32%、73.24%、69.01%,对万古霉素的耐药率最低为2.82%,屎肠球菌对环丙沙星、利福平以及高浓度庆大霉素的耐药率最高,分别为95.83%、94.79%、92.71%,对万古霉素的耐药率最低为5.21%。结论由于粪肠球菌以及屎肠球菌所导致的老年患者尿路感染,治疗可首选万古霉素,但是仍然需要重视对菌株的培养以及耐药性分析,减少抗菌药物的盲目运用,以有效降低耐药菌株的产生,同时提高治疗效果。OBJECTIVE To investigate drug resistance of Enterococcus f aecalis and Enterococcus f aecium in midstream urine of elderly patients with urinary tract infections ,so as to provide the basis for clinical treatment and analysis of drug resistance of Enterococcus in our hospital .METHODS A retrospective analysis was conducted on midstream urine specimens of elderly patients detected during Jul .2011‐Jul .2013 .Totally 71 E . f aecalis and 96 E . f aecium were isolated .The K‐B disk diffusion method was used for susceptibility testing ,and the software WHONET 5 .1 was used for data processing to analyze the resistance of Enterococcus .RESULTS The detection rate of Enterococcus was 33 .53% in the urology department ,23 .35% in the department of critical care medicine , 15 .57% in the endocrinology department . E .f aecalis was the most resistant to erythromycin ,tetracycline and ciprofloxacin ,with the resistance rate being 87 .32% , 73 .24% , 69 .01% respectively , and the lowest to vancomycin ,2 .82% . E . f aecium was the most resistant to ciprofloxacin , rifampin and highly‐concentrated gentamicin ,with the resistance rate being 95 .83% 94 .79% ,92 .71% respectively ,and the lowest to vancomycin , 5 .21% .CONCLUSION For elderly urinary tract infection caused by E .f aecalis and E . f aecium ,vancomycin may be the preferred treatment ,but there is still a need to pay attention to the cultivation of drug‐resistant strains and resistance analysis ,so as to reduce the blind use of antimicrobial drugs , thus to reduce generation of resistant strains and improve the therapeutic effect .

关 键 词：老年患者 尿路感染 粪肠球菌 屎肠球菌 耐药性 

分 类 号：R378[医药卫生—病原生物学]