肠球菌属细菌的临床分布与耐药性分析  

Clinical distribution and drug resistance of Enterococci

作　　者：岑叶平[1] 崔裕山 常燕子[2] 费红军[1] 张玲莉 CEN Yeping;CUI Yushan;CHANG Yanzi;FEI Hongjun;ZHANG Lingli(Ningbo College of Health Sciences,Ningbo,Zhejiang 315100,China)

机构地区：[1]宁波卫生职业技术学院,浙江宁波315100 [2]宁波市医疗中心李惠利医院,浙江宁波315041

出　　处：《中国微生态学杂志》2019年第10期1215-1218,共4页Chinese Journal of Microecology

摘　　要：目的了解2012-2017年临床分离肠球菌的分布特征及耐药性,为临床合理用药提供依据。方法采用全自动微生物分析仪进行菌株鉴定及药敏试验,对肠球菌的临床分布与耐药情况进行统计分析。结果共分离出1 432株肠球菌,其中粪肠球菌为603株(42.11%),屎肠球菌为596株(41.62%)。肠球菌属细菌标本来源以尿液、胆汁和全血为主,分别占39.66%、34.50%和11.59%,其中粪肠球菌主要来自普外科、泌尿外科和ICU,而屎肠球菌主要来自ICU、普外科和消化内科。肠球菌总体对红霉素的耐药率最高(67.81%),其次为四环素(47.49%)、环丙沙星(47.00%)和左旋氧氟沙星(46.44%),对利奈唑胺和万古霉素的耐药率较低,分别为4.89%和1.19%。粪肠球菌对奎奴普丁/达福普汀、四环素的耐药率分别为83.91%和64.01%,明显高于屎肠球菌(均P<0.05)。屎肠球菌对红霉素、青霉素G、氨苄西林、喹诺酮类的耐药率均超过85.00%,且均高于粪肠球菌(均P<0.05)。粪肠球菌和屎肠球菌对利奈唑胺的耐药率分别为6.80%和2.18%,对万古霉素的耐药率分别为0.66%和0.67%。结论肠球菌感染病原菌以粪肠球菌和屎肠球菌为主,肠球菌属细菌对万古霉素和利奈唑胺仍然保持较高的敏感性,不同种的肠球菌其耐药性差异显著。Objective To investigate the clinical distribution and drug resistance of Enterococcusisolates from 2012to 2017,and provide evidence for rational clinical drug use.Methods Automatic microbiological analyzer was used to identify the strains and determine drug sensitivities.The clinical distribution and drug resistance of Enterococcus faecalis and Enterococcus faecium were analyzed.Results A total of 1,432strains of Enterococci were isolated,in which Enterococcus faecalis(603strains)accounted for 42.11%while Enterococcus faecium(596strains)accounted for 41.62%.The Enterococcus faecalis and Enterococcus faecium specimens were mainly from urine,accounting for 44.94%and 47.65%,respectively.Enterococcus faecalis mainly came from general surgery,urology and ICU departments,while Enterococcus faecium was mainly from ICU,general surgery and digestive medicine departments.Enterococci had the highest resistance rate to Erythromycin(67.81%),followed by Tetracycline(47.49%),Ciprofloxacin(47.00%)and Levofloxacin(46.44%).The resistance rates to Linezolid and Vancomycin were lower(4.89%and 1.19%,respectively).The resistance rates of Enterococcus faecalis to Quinoputin/Dafostine and Tetracycline were 83.91%and 64.01%respectively,significantly higher than those of Enterococcus faecium(all P<0.05).The resistance rates of Enterococcus faeciumto Erythromycin,Penicillin G,Ampicillin and Quinolones were all over 85.00%and higher than those of Enterococcus faecalis(all P<0.05).The resistance rates of Enterococcus faecalis and Enterococcus faeciumto Nezolid were 6.80%and 2.18%respectively,and to Vancomycin was 0.66%and 0.67%respectively.Conclusion Enterococcus faecalis and Enterococcus faecium were the main pathogens of enterococcal infections.Enterococciremain highly susceptible to Vancomycin and Linezolid.There are significant differences in drug resistance among different strains of Enterococci.

关 键 词：粪肠球菌 屎肠球菌 抗菌药物 耐药性 

分 类 号：R378[医药卫生—病原生物学]