某院肠球菌属耐药性变迁及其与抗菌药物使用的相关性研究  

Study on Drug Resistance Changes of Enterococcus Spp and Its Correlation with Use of Antimicrobial Drugs in a Hospital

作　　者：徐锦 陈欢[1] 郑春玲 陈白灵 梁春燕 刘智君 隆丽娜 何科[1] XU Jin;CHEN Huan;ZHENG Chun-ling;CHEN Bai-ling;LIANG Chun-yan;LIU Zhi-jun;LONG Li-na;He Ke(Yulin Orthopedics Hospital of Chinese and Western Medicine,Yulin,Guangxi 537000;Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine,Nanning 530000)

机构地区：[1]玉林市中西医结合骨科医院,广西玉林537000 [2]广西中医药大学附属瑞康医院,南宁530000

出　　处：《抗感染药学》2022年第4期477-481,486,共6页Anti-infection Pharmacy

基　　金：玉林市科学研究与技术开发计划项目(编号:201934053)。

摘　　要：目的:分析医院肠球菌属的检出情况和耐药变迁,以及其与抗菌药物使用的相关性,为临床治疗肠球菌属感染提供参考。方法:收集2015年1月—2019年12月玉林市中西医结合骨科医院收治的微生物培养结果为肠球菌属的住院患者的病历资料,统计肠球菌属的标本来源和历年的耐药情况,采用Pearson相关性分析法分析肠球菌属的耐药变化与抗菌药物使用的相关性。结果:2015年1月—2019年12月,医院住院患者标本中共分离出肠球菌属593株,其中粪肠球菌510株(占86.00%)、屎肠球菌83株(占14.00%);粪肠球菌以从分泌物标本中检出为最多(418株,占81.96%),屎肠球菌则主要检出自分泌物(44株,占53.01%)和尿液(37株,占44.58%);5年间,粪肠球菌和屎肠球菌对万古霉素、替加环素的耐药率始终较低(<10.00%),粪肠球菌对呋喃妥因的耐药率亦始终较低(<10.00%),屎肠球菌则对利奈唑胺的耐药率始终较低(<10.00%);粪肠球菌对青霉素、环丙沙星、左氧氟沙星、利奈唑胺的耐药率相对较低(<30.00%),但对青霉素的耐药率逐年下降,对利奈唑胺的耐药率则逐年上升;屎肠球菌对青霉素、环丙沙星、左氧氟沙星、四环素的耐药率均较高(>50.00%);Pearson相关性分析结果显示,粪肠球菌对环丙沙星、左氧氟沙星的耐药率与环丙沙星的抗菌药物使用强度呈负相关性。结论:肠球菌属的耐药变迁与部分抗菌药物的使用强度具有相关性,医院应当加强抗菌药物的管理,促进临床科学、合理使用抗菌药物,避免或减少耐药菌株的产生。Objective:To analyze the detection of Enterococcus spp and drug resistance changes in the hospital as well as its correlation with the use of antimicrobial drugs,and provide reference for clinical treatment of Enterococcus spp infections.Methods:The medical records of inpatients with microbiological culture results of Enterococcus spp who were admitted to Yulin Orthopedics Hospital of Chinese and Western Medicine from January 2015 to December2019 were collected,the specimen sources of Enterococcus spp and the drug resistance over the years were counted,and the correlation between drug resistance changes of Enterococcus spp and use of antimicrobial drugs was analyzed by Pearson correlation analysis.Results:From January 2015 to December 2019,593 Enterococcus spp strains were isolated from specimens of inpatients in the hospital,including 510 Enterococcus faecalis(accounting for 86.00%)and83 Enterococcus faecium(accounting for 14.00%);most of Enterococcus faecalis were detected from secretion specimens(418 strains,accounting for 81.96%),while Enterococcus faecium were mainly detected from secretion(44 strains,accounting for 53.01%)and urine(37 strains,accounting for 44.58%).During the five years,Enterococcus faecalis and Enterococcus faecium always had low resistance rates(<10.00%)to vancomycin and tigecycline,Enterococcus faecalis always had a low resistance rate(<10.00%)to furantoin,while Enterococcus faecium always had a low resistance rate(<10.00%)to linezolid;Enterococcus faecalis had a relatively low resistance rate(<30.00%)to penicillin,ciprofloxacin,levofloxacin and linezolid,but its resistance rate to penicillin decreased year by year and resistance rate to linezolid increased year by year;Enterococcus faecium had a high resistance rate(>50.00%)to penicillin,ciprofloxacin,levofloxacin and tetracycline;Pearson correlation analysis results showed that the resistance rate of Enterococcus faecalis to ciprofloxacin and levofloxacin was in negative correlation to the antibiotics use density of ciprofloxacin.Concl

关 键 词：肠球菌属 耐药变迁 抗菌药物使用强度 Pearson相关性分析 

分 类 号：R915[医药卫生—微生物与生化药学] R969.3[医药卫生—药学]