114例医院内鹑鸡肠球菌感染病例的临床分析  

Clinical characteristics in 114 cases of Enterococcus gallinarum nosocomial infection

作　　者：刘芳 周利 彭懿 LIU Fang;ZHOU Li;PENG Yi(Department of Pharmacy,Traditional Chinese Medicine Hospital of Xiangtan,Xiangtan Hunan 411228)

机构地区：[1]湘潭县中医医院药学部,湖南湘潭411228

出　　处：《中南药学》2025年第1期258-261,共4页Central South Pharmacy

摘　　要：目的分析我院鹑鸡肠球菌耐药情况,为临床合理使用抗菌药物提供依据,减少细菌耐药风险。方法回顾性分析我院2018—2023年分离出的114株鹑鸡肠球菌的病例特点、耐药分布情况,并对疗效进行判断。结果鹑鸡肠球菌全部病例均为医院内感染,尿液标本检出率最高(88.60%),感染平均年龄为(67.26±13.67)岁,其中43.86%合并冠心病;在鹑鸡肠球菌感染前78.07%的患者留置了导尿管,13.16%和1.75%的患者曾行气管插管和气管切开,75.44%的患者曾使用抗菌药物;体外药敏试验结果显示鹑鸡肠球菌对利奈唑胺(96.49%)、替加环素(93.86%)、万古霉素(93.86%)敏感性较好,对高浓度氨基糖苷类、米诺环素、呋喃妥因敏感率亦可(≥50.00%),对青霉素、氨苄西林、红霉素、加替沙星、左氧氟沙星耐药率>70.00%;治疗无效组的患者存在年龄稍高(68.75±18.89)岁、女性较多、APACHEⅡ评分≥20分、合并2种及以上的基础疾病的临床特征,治疗总体有效率为96.49%(110/114);治疗有效组来自非无菌标本(99.07%,107/108)多于无菌标本(50.00%,3/6),使用敏感抗菌药物有效率为90.91%(30/33),使用非敏感抗菌药物有效率为98.77%(80/81),无菌标本(100.00%,6/6)相对于非无菌标本(25.00%,27/108)临床更倾向于选用敏感的抗菌药物。结论鹑鸡肠球菌感染人群主要为老年人、合并基础疾病、曾行侵袭性操作和使用广谱抗菌药物的患者;该菌耐药率普遍较高,抗菌药物选择有限,应根据药敏试验结果选择合适的抗菌药物;女性重症患者且合并多种基础疾病治疗难度更大,无菌标本较非无菌标本临床更倾向选用敏感的抗菌药物,但非无菌标本治疗有效率高于无菌标本。Objective To determine the drug resistance of Enterococcus gallinarum in a hospital and provide evidence for the rational use of antibiotics and reduce the risk of drug resistance.Methods The characteristics and drug resistance distribution of 114 strains of Enterococcus gallinarum isolated in a hospital from 2018 to 2023 were retrospectively analyzed,and the therapeutic effect was evaluated.Results All the cases were nosocomial infection.The urine samples had the highest detection rate(88.60%).The average age of infected patients was(67.26±13.67)years old,43.86%of whom were complicated with coronary heart disease.Before Enterococcus gallinarum infection,78.07%of the patients had implanted urine catheter,13.16%and 1.75%had intubation and tracheotomy,75.44%had antibiotics.In vitro drug sensitivity showed that Enterococcus gallinarum quail gallinae was sensitive to linezolid(96.49%),tigacycline(93.86%)and vancomycin(93.86%),and was also sensitive to high concentrations of aminoglycosides,minocycline and furantoin(sensitivity≥50.00%).The drug resistance rate to penicillin,ampicillin,erythromycin,gatifloxacin,and levofloxacin was higher than>70.00%.Patients in the ineffective treatment group were slightly older(68.75±18.89)years old,more females,APACHEⅡscore≥20,and complicated two or more other diseases.The overall effective rate of the treatment was 96.49%(110/114).The effective treatment group had 99.07%(107/108)from non-sterile samples more than 50.00%(3/6)from sterile samples.The effective rate of using sensitive antibiotics was 90.91%(30/33),while that of nonsensitive antibiotics was 98.77%(80/81).For sterile samples 100%(6/6)sensitive antibiotics were more likely used use than for non-sterile samples 25.00%(27/108).Conclusion Enterococcus gallinarum infection mainly occurs in the elderly patients with primary diseases,especially those who undergo invasive operations and use broad-spectrum antibiotics.The drug resistance rate of the bacteria is generally high,the antibiotics selection is limited,so appro

关 键 词：鹑鸡肠球菌 耐药性 抗菌药物 合理用药 

分 类 号：R969.3[医药卫生—药理学]