2012 - 2017年开封市粪肠球菌和屎肠球菌耐药性变迁分析

目的 了解粪肠球菌及屎肠球菌对常用抗菌药物的耐药变迁情况，为临床合理用药提供依据。方法 对2012 - 2017年间临床分离的397株粪肠球菌和497株屎肠球菌的药敏试验结果进行分析。结果 屎肠球菌对红霉素、利福平、环丙沙星、左氧氟沙星、青霉素、氨苄西林、庆大霉素、呋喃妥因和四环素等9种抗菌药物的平均耐药率均高于60%，对庆大霉素、呋喃妥因和链霉素3种抗菌药物耐药率不同年份呈上升趋势，对氯霉素耐药率呈下降趋势。粪肠球菌对红霉素、利福平、四环素和喹奴普汀 - 达福普汀等4种抗菌药物的平均耐药率高于60%，对氨苄西林和青霉素2种抗菌药物耐药率不同年份呈上升趋势，对环丙沙星、左氧氟沙星和庆大霉素3种抗菌药物耐药率呈下降趋势。屎肠球菌及粪肠球菌对替考拉宁和万古霉素2种抗菌药物平均耐药率均低于1%。结论 屎肠球菌和粪肠球菌对14种常用抗菌药物的耐药性变迁总体呈上升趋势，且屎肠球菌对常用抗菌药物的耐药性较高，故临床治疗应根据药敏结果选择合适的抗菌药物。

Analysis of drug resistance changes of Enterococcus faecalis and Enterococcus faecium in Kaifeng from 2012 to 2017

Objective The aim of this study was to assess the changes of drug resistance of Enterococcus faecalis and Enterococcus faecium to common antimicrobial drugs, and provide the basis for clinical rational use of drugs. Methods The results of drug sensitivity test of 397 strains of Enterococcus faecalis and 497 strains of Enterococcus faecium clinically isolated between 2012 and 2017 were analyzed. Results The average resistance rate of Enterococcus faecium to erythromycin, rifampicin, ciprofloxacin, levofloxacin, penicillin, ampicillin, gentamicin, pharmorubicin and tetracycline were higher than 60%. The resistance rates to gentamicin, nitrofurantoin and streptomycin increased in different years, but to chloramphenicol decreased. The average resistance rate of Enterococcus faecalis to erythromycin, rifampicin, tetracycline and quinupristin dalfopristin was higher than 60%. The resistance rates to ampicillin and penicillin increased in different years, but to ciprofloxacin, levofloxacin and gentamicin decreased. The average resistance rates of Enterococcus faecium and Enterococcus faecalis to teicoplanin and vancomycin were lower than 1%. Conclusion The resistance of Enterococcus faecium and Enterococcus faecalis to 14 commonly used antimicrobial agents was on the rise, and Enterococcus faecium had high resistance to commonly used antibiotics. So, clinical treatment should select appropriate antibacterial drugs based on drug susceptibility results.