粪肠球菌和屎肠球菌的耐药特征

目的了解粪肠球菌和屎肠球菌在临床标本中的分布及对常用抗菌药物的耐药性,比较不同标本中两种肠球菌的耐药性,为临床治疗提供参考。方法常规法进行菌种鉴定,纸片扩散法进行药物敏感试验。结果420株肠球菌属,来源于尿液、脓液分泌物、痰液,分别占43%、20%、14%位居各类标本中的前3位,粪肠球菌对青霉素、氨苄西林和哌拉西林/他唑巴坦的耐药率分别为23.0%、17.6%和21.2%,明显低于屎肠球菌对这3种抗菌药物的耐药率(90.0%、87.0%和87.7%),而屎肠球菌对氯霉素和四环素的耐药率分别为7.9%和24.6%,明显低于粪肠球菌对这两种抗菌药物的耐药率(43.8%和74.4%),两种肠球菌中,未发现万古霉素耐药株;尿液标本中粪肠球菌对呋喃妥因的耐药率明显低于屎肠球菌。结论临床标本中,肠球菌属在尿液中的分布最高;粪肠球菌和屎肠球菌的耐药谱明显不同,在治疗时,应根据不同的菌种选择用药,由于肠球菌属对万古霉素的耐药率极低,在重症感染时,可选用万古霉素进行治疗。

Resistant Characteristics of Enterococcus faecalis and E. Faecium

OBJECTIVE To investigate the distribution and resistance of Enterococcus faecalis and E.faecium,and compare the resistance of them in different specimens. METHODS Bacteria were identified by routine methods.Susceptibility test was performed by K-B methd. RESULTS Of 420 clinical isolates,43% were from urine,20% from pus,14% were from sputum.Resistance rates of E.faecalis to penicillin,ampicillin and piperacillin/tazobactam were 23%,17.6% and 21.2%,respectively.They were lower than E.faecium(90%,87% and 87.7%).Resistance rates of E.faecium to chloramphenicol and tetracycline were 7.9% and 24.6%,respectively.They were lower than E.faecalis(43.8% and 74.4%).No strains were resistant to vancomycin.Resistance rates were no different in urine,pus and sputum.But resistance rates of E.faecalis to nitrofurantoin were lower than that of E.faecium. CONCLUSIONS The distribution rate of Enterococcus spp in urine specimens is the highest.Resistance of E.faecalis and E.faecium is different.We should choose vancomycin in severe infection.