万古霉素耐药肠球菌对院内肠球菌肺部感染预后的影响

目的 探讨万古霉素耐药肠球菌对医院内肺部感染预后的影响。方法 应用回顾性调查的方法对1993年1月～2001年12月96例医院内肺部肠球菌感染病人进行分析。结果 96例院内肺部肠球菌感染以粪肠球菌为多(73％)，屎肠球菌次之(22％)。肠球菌对临床常用抗生素的耐药率高，对万古霉素的耐药率为12．5％，屎肠球菌的耐药率明显高于粪肠球菌。96例肺部肠球菌感染患者，病死率40％(38/96)。感染的肠球菌对万古霉素耐药的病人病死率最高，达92％，明显高于万古霉素敏感肠球菌肺感染的病死率(26％)(P＜0．05)。结论 万古霉素耐药肠球菌肺感染发病率呈上升趋势，病死率高，需引起临床的高度重视。

Prognostic effect of vancomycin-resistant enterococci on nosocomial pulmonary infections caused by enterococci

Objective To investigate the prognosis effect of vancomycin-resistant enterococci(VRE) on nosocomial pulmonary infections caused by enterococci. Methods 96 cases with nosocomial pulmonary infections caused by enterococci were retrospectively analysed. Results Enterococcus faecalis was ranked the first pathogen (73%) and E.faecium was the second one (22%). In 96 enterococcal strains, the resistant rate to vancomycin was 12.5%, and very high to other antibacterial agents. Different species in enterococci had different drug resistance, and resistant rate in E.faecium was much higher than that in E.faecalis . The mortality of nosocomial pulmonary infections caused by Enterococci was 40%. The mortality of the patients infected by vancomycin-resistant enterococci was the highest (92%) and was higher than that of patients infected by vancomycin-sensitive enterococci (26%) ( P <0.05). Conclusion The morbidity of nosocomial pulmonary infections caused by VRE is rising and the mortality is very high, and this problem is worthy of particular mention.