2010—2014年新疆维吾尔自治区人民医院临床分离肠球菌属细菌的分布及耐药性分析  

Distribution and antibiotic resistance of the Enterococcus isolates in the People's Hospital of Xinjiang Uygur Autonomous Region during the period from 2010 to 2014

作　　者：罗斌[1] 李娟[1] 

机构地区：[1]新疆维吾尔自治区人民医院临床检验中心,乌鲁木齐830001

出　　处：《中国感染与化疗杂志》2016年第4期481-485,共5页Chinese Journal of Infection and Chemotherapy

基　　金：新疆维吾尔自治区人民医院院内课题(20130307)

摘　　要：目的了解新疆维吾尔自治区人民医院2010-2014年临床标本中分离的肠球菌属细菌的分布特点及对抗菌药物的耐药情况。方法采用VITEK 2-Compact全自动微生物分析仪对临床标本分离出的1 937株肠球菌进行菌种鉴定,药敏分析采用AST-GP67药敏卡及纸片扩散法,采用当年CLSI推荐的标准执行。结果在1 937株肠球菌中,屎肠球菌1 091株(56.3%)、粪肠球菌672株(34.7%)。泌尿系统感染病原菌屎肠球菌和粪肠球菌分别占总数的59.9%和53.1%。2010-2014年粪肠球菌对各种抗菌药物的耐药率远低于屎肠球菌;屎肠球菌和粪肠球菌除对利奈唑胺耐药率较低外,屎肠球菌对万古霉素、替考拉宁的耐药率上升较快,前者由2010、2011年为0到2012年2.2%和2014年7.3%,后者也由2010、2011为0和2012年1.4%到2014年4.9%;对高浓度庆大霉素和链霉素耐药菌株占肠球菌的34.4%;屎肠球菌对青霉素、氨苄西林的耐药率(89.5%、86.9%)明显高于粪肠球菌(12.8%、11.8%)。共检出耐万古霉素肠球菌(VRE)39株,且VRE对抗菌药物的耐药率总体明显高于非VRE。结论肠球菌在泌尿系感染中占重要位置;屎肠球菌耐药率明显高于粪肠球菌,尤其是高浓度氨基糖苷类耐药和VRE的耐药率有逐年上升趋势,应加强对耐药菌株的监测和防控。Objective To understand the distribution and antibiotic resistance of the Enterococcus isolates in this hospital. Methods A total of 1 937 strains of Enterococcus were isolated from clinical specimens and identified by VITEK 2-Compact automatic system. The AST-GP67 card and Kirby-Bauer method were used to test the susceptibility of the isolates. Results Of the 1 937 strains, 1 091 （56.3 %） were E. faecium, and 672 （34.7 %） were E. faecalis. Most of the E. faecium （59.9 %） and E. faecalis （53.1%） strains were isolated from urinary system From 2010 to 2014, E. faecalis isolates were generally less resistant than E. faecium to various antibiotics. Both E. faecalis and E. faecium kept low resistance to linezolid. However, E. faecium showed increasing resistance to vancomycin from 0 in 2010/2011 to 2.2 % in 2012, and 7.3 % in 2014; and to teicoplanin from 0 in 2010/2011, to 1.4 % in 2012, and 4.9 % in 2014. Overall, 34.4 % of the Enterococcus strains were resistant to high level gentamicin and streptomycin. E. faecium isolates showed higher resistance rates to penicillin and ampicillin （89.5 % and 86.9 %） than E. faecalis（12.8 % and 11.8 %）. Vancomycin resistance was identified in 39 of the Enterococcus strains. VRE isolates were generally more resistant than non-VRE isolates. Conclusions Enterococcus plays an important role in urinary tract infections. E. faecium showed much higher resistance rates than E. faecalis. It seems that the prevalence of VRE and high-level aminoglyeoside- resistant Enterococcus is increasing. Such resistant strainsshould be under close monitoring and careful control.

关 键 词：肠球菌 感染 抗生素 耐药率 

分 类 号：R446.5[医药卫生—诊断学]