两种肠球菌致重症患者尿路感染的耐药性比较  

Comparative analysis of drug resistance of pathogens in ICU patients with urinary tract infections caused by two kinds of Enterococcus

作　　者：叶小翠[1] 姚建凤[2] 黄荣富[1] 

机构地区：[1]福建医科大学附属第二医院检验科,福建泉州362000 [2]泉州市儿童医院生殖医学中心,福建泉州362000

出　　处：《中国微生态学杂志》2016年第2期205-209,共5页Chinese Journal of Microecology

摘　　要：目的研究粪肠球菌和屎肠球菌致重症患者尿路感染现状并对其耐药特征进行比较分析,为临床合理选用抗菌药物,有效预防和控制感染提供依据。方法对2011年1月至2014年12月福建医科大学附属第二医院重症监护室尿路感染患者分离的172株肠球菌进行分析,用法国生物梅里埃Vitek2-Compact微生物鉴定仪鉴定肠球菌,K-B纸片扩散法进行药敏试验,利用WHONET 5.6软件分析处理试验数据。结果 172株肠球菌中,粪肠球菌和屎肠球菌分别占68.0%和32.0%;药敏试验表明两种肠球菌对利奈唑胺、万古霉素、替考拉宁都较敏感(耐药率<5.0%),未检出对替加环素耐药的菌株,除这4种药物外,对其余12种抗菌药物差异存在统计学意义(χ2=36.15,P<0.05)。4年间粪肠球菌除对四环素、替加环素外,屎肠球菌除对四环素、庆大霉素(高浓度)、替加环素外,对其余抗菌药物的耐药率的变化均呈显著升高的趋势(χ2=16.71,P<0.05)。结论从该院重症患者尿液标本中分离出的肠球菌多重耐药严重,对大多数抗菌药物的耐药率呈逐年升高的趋势,两种肠球菌的耐药性存在菌种差异,临床应加强细菌监测,治疗肠球菌感染时首选利奈唑胺、万古霉素、替考拉宁、替加环素。Objective To study the urinary tract infection of ICU patients caused by Enterococcus faecalis and Enterococcus faecium and drug resistance,and provide basis for rational use of antimicrobial drugs.Methods 172 strains of Enterococci isolated from patients with urinary tract infections in the ICU from January 2011 to December 2014 were identified with French bioMerieux Vitek2-Compact microbial identification system.Drug susceptibility test was performed using K-B disk diffusion method,and the data were analyzed using WHONET 5.6software.Results In the 172 strains,Enterococcus faecalis and Enterococcus faecium accounted for respectively 68.0%？and 32.0%;both were sensitive to Linezolid,Vancomycin and Teicoplanin？（resistance rate〈5.0%）;strains resistant to？Tigecycline were not detected.The resistances to the other 12 antibacterial agents were significantly different（P〈0.05）.The resistances of Enterococcus faecalis（except to Tetracycline and Tigecycline）and Enterococcus faecium（except to Tetracycline,high-dose Gentamycin and Tigecycline）significantly increased during the four years（P〈0.05）.Conclusion The Enterococci isolated from urine samples of ICU patients in our hospital are highly multi-drug resistant and their resistance rates to most anbiotics showed an increasing trend,and the resistances are different between the two types of Enterococci.Bacterial surveillance should be strengthened;Linezolid,Vancomycin,Teicoplanin and Tigecycline？can be used as the preferred choices of drugs for treating Enterococcus infection.

关 键 词：肠球菌 重症患者 尿路感染 耐药性 

分 类 号：R446.5[医药卫生—诊断学]