2010-2014年肠球菌属临床分布与耐药性监控  

Clinical distribution and antibacterial monitor of Enterococcus spp.from 2010 to 2014

作　　者：楚旭[1] 毛剑锋[1] 董华丽[1] 张传领[1] 郭远瑜[1] 沈利蒙[1] 

机构地区：[1]浙江萧山医院检验科,浙江杭州311202

出　　处：《中华医院感染学杂志》2016年第19期4354-4357,共4页Chinese Journal of Nosocomiology

基　　金：浙江省医药卫生科技计划基金资助项目(2012KYB171)

摘　　要：目的分析肠球菌属感染的临床分布及其耐药性,为临床合理使用抗菌药物提供依据。方法收集2010-2014年医院临床分离肠球菌属,应用VITEK-2Compact微生物全自动分析系统进行鉴定,采用AST-GP67药敏卡进行药敏试验,用WHONET5.6软件分析肠球菌属的分布及耐药性。结果 2010-2014年共分离出482株肠球菌属,其中粪肠球菌286株、屎肠球菌153株,主要来源于尿液、引流液和血液;粪肠球菌对氨苄西林、青霉素、红霉素、环丙沙星、左氧氟沙星、莫西沙星、高浓度庆大霉素、高浓度链霉素、呋喃妥因、万古霉素等10种抗菌药物耐药率分别为24.1%、19.2%、66.4%、18.5%、19.2%、19.2%、38.1%、30.4%、0.3%、0.3%,明显低于屎肠球菌94.1%、92.2%、91.5%、93.5%、88.2%、89.5%、70.6%、49.0%、40.5%、2.6%,粪肠球菌对喹奴普汀/达福普汀、四环素耐药率分别为100.0%、76.6%,明显高于屎肠球菌0、42.5%;2010-2014年粪肠球菌及屎肠球菌对常用抗菌药物耐药率无明显趋势变化。结论粪肠球菌和屎肠球菌主要分布于尿液、引流液和血液,对多种抗菌药物的耐药率存在较大差异,临床应根据药敏试验结果合理选择抗菌药物。OBJECTIVE To analyze the clinical distribution and drug resistance of Enterococcus spp.,so as to provide guidance for rational use of antibacterial agents.METHODS Enterococcus spp.were clinically isolated and collected from our hospital from Jan.2010 to Dec.2014,identified by VITEK-2Compact automated microbial analysis system,and given GPS-AST67 susceptibility cards to test antibiotics susceptibility.The distribution and antibacterial resistance of Enterococcus spp.were analyzed by WHONET 5.6.RESULTS A total of 482 strains of Enterococcus spp.were isolated from 2010-2014,including 286 strains of Enterococcus faecalis and 153 strains of Enterococcus faecium,and most of these were from urine,drainage liquid and bloodstream.The resistance rates of E.faecalis to ampicillin,penicillin,erythromycin,ciprofloxacin,levofloxacin,moxifloxacin,gentamicin（high concentration）,streptomycin（high concentration）,nitrofurantoin,vancomycin were 24.1%,19.2%,66.4%,18.5%,19.2%,19.2%,38.1%,30.4%,0.3% and 0.3%,which were significantly lower than those of E.faecium（94.1%,92.2%,91.5%,93.5%,88.2%,89.5%,70.6%,49.0%,40.5% and 2.6%）.The resistance rates of E.faecalis to quinupristin/dalfopristin and tetracycline were 100.0%and 76.6%,significantly higher than E.faecium（0.0% and 42.5%）.There were no obvious trend changes of drug resistance rate of Enterococcus spp.from 2010 to 2014.CONCLUSIONThe main distribution of E.faecalis and E.faeciumis in urine,drainage liquid and bloodstream,and the resistance rates to a variety of antibacterial agents have large differences,so there should have a rational choice about antibacterial agents based on susceptibility testing in clinic.

关 键 词：粪肠球菌 屎肠球菌 分布 耐药性 

分 类 号：R378.1[医药卫生—病原生物学]