2009—2013年重庆地区儿童感染粪肠球菌和屎肠球菌的临床分布及耐药性分析  

Clinical distribution and drug resistance of Enterococcus faecalis and Enterococcus faecium isolates causing children infections in Chongqing from 2009 to 2013

作　　者：谢伟[1] 景春梅[1] 王偲[1] 

机构地区：[1]重庆医科大学附属儿童医院检验科儿童发育疾病研究教育部重点实验室儿科学重庆市重点实验室重庆市儿童发育重大疾病诊治与预防国际科技合作基地,重庆400014

出　　处：《中国抗生素杂志》2015年第8期611-616,共6页Chinese Journal of Antibiotics

基　　金：国家自然科学基金资助项目(No.81071417)

摘　　要：目的了解重庆地区儿童2009—2013年粪肠球菌和屎肠球菌的临床分布特征及耐药性,为合理应用抗菌药物和预防控制医院感染提供依据。方法分析2009—2013年检出的1122株粪肠球菌和屎肠球菌对11种抗菌药物的耐药性,采用BD Phoenix 100 MIC法结合K-B纸片扩散法进行药敏试验,按美国临床实验室标准化委员会(CLSI)标准判断结果。结果分离粪肠球菌(433株)和屎肠球菌(689株)共1122株,其中屎肠球菌(61.41%,689/1122),粪肠球菌(38.59%,433/1122);以尿标本多见,分别占56.81%(246株)和52.69%(363株)。未检出耐万古霉素粪肠球菌,检出1株耐万古霉素屎肠球菌,粪肠球菌和屎肠球菌对替考拉宁、利奈唑胺、呋喃妥因的耐药率分别0、0、5.96%和0.15%、0.29%、48.04%,其余抗菌药物耐药率均>50%以上。粪肠球菌和屎肠球菌在肾脏免疫病房和重症监护室的检出率明显高于其他病区(P<0.05)。屎肠球菌耐药性比粪肠球菌更严重(P<0.05)。结论重庆地区儿童感染的屎肠球菌耐药性比粪肠球菌更严重,且呈上升趋势,肾脏免疫病房和重症监护室是预防控制的重点科室。Objective To investigate clinical distribution and drug resistance of Enterococcus faecalis and Enterococcusfaecium isolates between January 2009 and December 2013 from Ch0ngqing＇s children and to provide the reference for reasonable use of antibiotics and prevention and control of nosocomial infections. Methods Identifications and antibiotic susceptibility tests （AST） of the total 1122 Enterococcus faecalis and Enterococcus faecium isolate were performed by BD Phoenix 100 automated system and the conventional Kirby-Bauer method. The AST results were interpreted according to the guidelines of the Clinical and Laboratory Standards Institute （CLSI）. Results A total of 1122 Enterococcus faecalis and Enterococcus faecium were isolated, including Enterococcusfaecium （61.41%, 689/1122）, Enterococcusfaecalis （38.59%, 433/1122）. The maximum number of Enterococcus Jaecalis and Enterococcusfaecium were isolated from urine. No strain of Enterococcus Jaecalis were resistant to vancomycin, however, only one strain of Enterococcus faecium was resistant to vancomycin. The susceptibility of Enterococcus faecalis were determined as 0 for teicoplanin, 0 for linezolid, 5.96% for nitrofurantoin, and Enterococcusfaecium as 0.15% for teicoplanin, 0.29% for linezolid, 48.43% for nitrofurantoin. The resistant rates to other testing drug were more than 50%. All in all, Enterococcus faecium was more resistant to antibiotics than EnterococcusJaecalis. The detection rates of the Enterococcusfaecalis and Entelvcoccusfaecium in nephrology rheumatology department and intensive care units were significantly higher than in other wards （P〈0.05）. Conclusion Enterococcus faecalis and Enterococcus faecium isolates trend towards higher rates of drug resistance, especially in Enterococcus faecium. It is necessary to focus on the prevention and control of the nosocomial infections in nephrology rheumatology department and intensive care units.

关 键 词：粪肠球菌 屎肠球菌 耐药性 儿童 

分 类 号：R378[医药卫生—病原生物学]