2016-2017年中国西部肠球菌属细菌耐药性监测

目的 总结2016-2017年中国西部地区临床分离肠球菌属细菌对各类抗菌药物的耐药性。方法 收集西部地区10家医院2016年1月-2017年12月临床分离的肠球菌属细菌，常规方法分离培养鉴定，用药敏纸片法、MIC法或E-test法测定细菌对抗菌药物敏感性，参照2017年CLSI标准判读药敏试验结果。结果 2016-2017年共分离到10959株肠球菌属细菌（非重复株），主要分离自尿标本(5259株，47.9%)，菌种分布为屎肠球菌(6431株，58.3%)、粪肠球菌(3912株，35.7%)、鸟肠球菌(201株，1.8%)、鹑鸡肠球菌(142株，1.3%)、铅黄肠球菌(123株，1.1%)。肠球菌属中鹑鸡肠球菌对万古霉素存在较高耐药率，其他菌种对利奈唑胺、万古霉素、替考拉宁、替加环素敏感率较高，屎肠球菌耐药率较粪肠球菌高。西部地区对万古霉素耐药的肠球菌属细菌检出率为1.1%，各省肠球菌属细菌间对抗菌药物的耐药率存在差异；分离菌株对利奈唑胺、万古霉素呈不同程度耐药。结论 肠球菌属细菌对抗菌药物的耐药情况严重，临床医师应结合具体药敏结果合理使用抗菌药物，并加强对耐药菌株的检测与防控。

Surveillance of Enterococcus antimicrobial resistance from hospitals in Western China during 2016—2017

Objective To investigate the antimicrobial resistance of Enterococcus strains isolated from 10 hospitals in Western China during the period from 2016 to 2017. Methods The Enterobacter spp. were collected from hospitals in Western China during January 1, 2016 through December 31, 2017. The antimicrobial susceptibility testing was carried out by means of the Kirby-Bauer method, MIC, and the E-test method according to the unified protocols. The data were analyzed using WHONET 5.6 software according to CLSI 2017 breakpoints. Results A total of 10,959 non-duplicate Enterococcus isolates were collected from 2016 through 2017. 5259 (47.9%) Enterococcus isolated from urine specimen and the most frequent species were E. faecium (6431 strains, 58.3%), E. faecalis (3,912 strains, 35.7%), E. avium (201 strains, 1.8%), E. gallinarum (142 strains, 1.3%), and E. casseliflavus (123 strains, 1.1%). In addition to the high resistance rate of E. gallinarum to vancomycin, the other species of Enterococcus were still highly susceptible to linezolid, vancomycin, teicoplanin and tigecycline. The E. faecium strains were more resistant than E. faecalis to most of the antibiotics tested. The resistance rate against vancomycinin hospitals in Western China was 1.1%. There were some differences in resistance of Enterococcus against linezolid and vancomycin among the western provinces. Conclusion The situation of Enterobacter bacteria resistant to antibiotics is serious. Clinicians should consider the antibiotics susceptibility results to rationally apply antibiotics and strengthen the detection and prevention of drug-resistant