重症监护病房耐万古霉素肠球菌耐药性分析  

Drug resistance of vancomycin-resistant Enterococcus strains in intensive care unit

作　　者：赵磊 陈炜 甄洁 顾红燕 臧学峰 陆非平 刘阳 张蕾 ZHAO Lei;CHEN Wei;ZHEN Jie;GU Hong-yan;ZANG Xue-feng;LU Fei-ping;LIU Yang;ZHANG Lei(Beijing Shijitan Hospital,Capital Medical University,Beijing 100038,China;不详)

机构地区：[1]首都医科大学附属北京世纪坛医院重症医学科,北京100038 [2]临床合理用药生物特征谱学评价北京市重点实验室,北京100038

出　　处：《中华医院感染学杂志》2021年第21期3246-3249,共4页Chinese Journal of Nosocomiology

基　　金：北京市自然科学基金资助项目(7153169,7123219);中国铁路总公司科技研究开发计划基金(J2014C011-H);临床合理用药生物特征谱学评价北京市重点实验室开放研究基金资助项目(2020-KF09);首都医科大学附属北京世纪坛医院院内科研基金(2012-C19,2013-C06);首都医科大学附属北京世纪坛医院院青年科研基金资助项目(2012-Q04)。

摘　　要：目的评价重症监护病房(ICU)内耐万古霉素肠球菌(VRE)的耐药性。方法回顾性分析2009年1月-2020年12月首都医科大学附属北京世纪坛医院ICU分离所得VRE 78株的药敏资料,采用WHONET 5.6软件进行统计分析。结果 VRE的出现有2011-2013年和2016年2个高峰,近年来呈下降趋势。78株VRE,其中屎肠球菌67株占比85.90%;主要来自尿液为53株占比67.95%,其次是血液14株和胸腹水10株;VRE总体喹奴普丁/达福普汀、利奈唑胺、替加环素、达托霉素敏感性高,对其他抗菌药物不敏感。屎肠球菌的耐药性高于其他肠球菌。结论 VRE对多种抗菌药物耐药,但对喹奴普丁/达福普汀、利奈唑胺、替加环素、达托霉素仍具备高度敏感性,肠球菌耐药性因种类不同,而有一定差异。OBJECTIVE To evaluate the drug resistance of vancomycin-resistant Enterococcus(VRE) strains in intensive care unit(ICU). METHODS Totally 78 strains of VRE were isolated from ICU of Beijing Shijitan Hospital, Capital Medical University from Jan 2009 to Dec 2020, the data of drug susceptibility testing for the strains were retrospectively analyzed, and statistical analysis was performed by using WHONET 5.6 software. RESULTS The VRE strains showed 2 peaks in 2011-2013 and 2016, presenting downward trends in recent years. Among the 78 strains of VRE, 67(85.90%) were Enterococcus faecium. 53(67.95%) strains were isolated from urine specimens, 14 strains were isolated from blood specimens, and 10 strains were isolated from hydrothorax and ascites. The VRE strains were highly sensitive to quinupristine-dafopristin, linezolid, tigecycline and daptomycin but were not sensitive to other antibiotics. The drug resistance of E.faecium was higher than that of other species of Enterococcus. CONCLUSION The VRE strains are resistant to multiple antibiotics but were highly sensitive to quinupristine-dafopristin, linezolid, tigecycline and daptomycin. Enterococcus vary in the drug resistant due to the different species.

关 键 词：重症监护病房 万古霉素耐药 肠球菌 耐药性 

分 类 号：R378.1[医药卫生—病原生物学]