肠球菌菌型分布及耐药性分析与医院感染

目的:分析临床分离肠球菌的菌群特点和对常用抗生素的耐药性,为控制医院感染提供指导性依据。方法:收集2000年1月至2003年12月间分离的肠球菌菌株,用法国梅里埃产品VITEK32全自动微生物分析系统进行鉴定和药敏试验。结果:共分离肠球菌410株,其中粪肠球菌234株,屎肠球菌152株,其他肠球菌24株。标本来源依次为尿液33.0%,分泌物14.9%,生殖道分泌物10.1%,痰8.8%,伤口分泌物5.1%,血液4.0%,肠球菌对万古霉素、替考拉宁、呋喃妥因、氨苄西林、青霉素G以及高浓度庆大霉素的耐药率分别为1.8%、3.3%、9.5%、33.3%、34.8%和40.2%,除万古霉素,替考拉宁外,屎肠球菌对常用抗生素的耐药率均显著高于粪肠球菌,耐氨苄西林株氨和氨基糖甙类高水平耐药株的分离率分别为42.1%和28.5%。结论:肠球菌的临床分布较广,对常用抗生素的耐药性较严重,应重视对送检标本的细菌培养,鉴定和药敏试验,临床应动态监测细菌耐药性的变化,加强对使用抗生素的管理,根据培养结果鉴定选择抗生素。

Analysis of Distribution of Various Enterococcus and Their Antimicrobial Resistance Corresponding the Internal Hospital Infection

Objective Analyzing the characteristics of enterococcus (E) colony in variety and their antimicrobial resistance against the normal antibiotics.Methods Performing the tests of drug sensitivities and analyzing the separated enterococus samples which have been collected from Jan 2000 to Dec 2003 by biomerrieux VITEK-32 automatic microorganism system.Results There are 410 E samples have been apart individually totally,thereinto 234 enterococcus faecalis (E.faecalis),152 enterococcus faecium (E.faecium),and 24 of others types of E samples.The origin of the samples were from urine 33%,secretion 14.9%,genital secretion 10.1%,sputum 8.8%,wounded secretion 5.1%,blood 4.0%.The antimicrobial resistance rates of E samples against the vancomycin,teicoplanin,nitrofurantoin,ampicillin,chloramphenicol and high-level genlamicin are 1.8%,3.3%,9.5%,33.3%,40.2% respectively.The antimicrobial resistance of E.faecalis is significant higher than that of E.faecium against the normal antibiotics except the vancomycin and teicoplanin.Conclusion The clinical distributing of enterococcal widely exists,and their antimicrobial resistance against the antibiotics is also strong.The germiculture of the testing samples must be essential.It is critical important to perform the drug sensitivity test,monitor dynamically the changing of the properties of antimicrobial resistance,strengthen the control of using antibiotics,and choose the proper antibacterial medicine.