不同标本类型分离的肠球菌临床耐药情况分析  

Antimicrobial resistance of Enterococcus spp. isolated from different type of specimens

作　　者：袁余[1] 王远芳[1] 戴仲秋 邓劲[1] 肖玉玲[1] 陈知行[1] 康梅[1] 谢轶[1] 

机构地区：[1]四川大学华西医院实验医学科微生物室,四川成都610041

出　　处：《现代预防医学》2017年第13期2493-2496,共4页Modern Preventive Medicine

摘　　要：目的对不同标本来源的肠球菌临床资料进行分析,了解其耐药分布及变迁趋势,为临床治疗不同部位肠球菌感染提供依据。方法收集2015至2016年6月检出肠球菌3 237株,对其标本分布特征及不同标本类型肠球菌耐药情况进行统计分析。结果分离出屎肠球菌1 870株,粪肠球菌1 367株。标本分布类型为尿液42%,分泌物21%,血培养19%,腹水胆汁18%。不同标本类型屎肠球菌及粪肠球菌对常用抗菌药物耐药情况较严重,除四环素和利奈唑胺,屎肠球菌对常用抗菌药物整体耐药率明显高于粪肠球菌。屎肠球菌中尿液标本整体耐药率显著高于其他组(P<0.05),粪肠球菌中腹水、胆汁标本整体耐药率较低(P<0.05)。不同标本类型肠球菌对多种常用抗菌药物耐药率差异较明显,差异有统计学意义(P<0.05)。结论肠球菌引起的感染耐药情况严重,临床治疗肠球菌感染时,应根据菌种差异、不同标本类型反应的不同感染部位,合理选用抗菌药物。Objective To investigate the drug resistance distribution of Enterococcuz through retrospectively reviewing clinical data isolated from different types of samples and to provide evidence for clinical treatment. Methods Clinical data of 3237 Enterococcus strains from 2015 - 2016 were collected and their distribution characteristics and drug resistance of different samples were analyzed. Results 1870 （58%） Enterococcus faecium strains and 1367 （42%） Enterococeus faecalis strains were isolated. All Enterocoecus strains were from urine 42%, seereta 21% , blood 19% , aseites and bile 18%. The rate of drug resistance to commonly used antibiotics in E.faecium and E. faecalis was high, while their resistant rate to vancomycin and linezolid was lower than 10%. E.faecium resistant to commonly used antibiotics was significantly higher than E.faecalis except for tetracycline and linezolid. The drug resistance rate of E.faecium from urine was significantly higher than strains from the other sample types（ P 〈 0.05 ）. The total drug resistance rate of E.faecalis from the aseites and bile samples was low（ P 〈 0. 05 ）. There were significant differences in drug resistance rates among different specimens of different Enterococcus strains （P 〈 0. 05 ）. Conclusion Enterococcus infection has serious drug resistance. According to the differences of the strains and different types of specimens, antimicrobial agents should be used rationally in the clinical treatment of Enterococcus infection.

关 键 词：肠球菌 感染 屎肠球菌 粪肠球菌 耐药率 

分 类 号：R113[医药卫生—公共卫生与预防医学]