粪、屎肠球菌对9种常用抗生素的敏感性分析

目的分析我院2003—2006年临床标本分离的粪、屎肠球菌对9种常用抗生素的敏感性，为临床医生提供粪、尿肠球菌感染的治疗对策。方法应用VITEK-32微生物系统回顾性分析近4a我院粪肠球菌、屎肠球菌对抗生素的敏感性。结果432株粪、屎肠球菌在临床分离的所有肠球菌中占77．0％，其中粪肠球菌为274株（48．8％），屎肠球菌为158株（28．2％）。粪肠球菌、屎肠球菌51起的感染部位有差异，前3位分离粪肠球菌的临床标本依次为尿液46．0％、脓性分泌物31．0％、痰液18．6％。分离屎肠球菌的临床标本依次为尿液75．9％、脓性分泌物15．8％、痰液5．1％。粪肠球菌对呋喃妥因、力奈唑烷、万古霉素敏感率〉90％，对高浓度的庆大霉素、链霉素、四环素、左氧氟沙星和莫昔沙星敏感率〈50％。屎肠球菌对力奈唑烷、万古霉素敏感率〉90％，对四环素敏感率78％～88％。对高浓度的庆大霉素、链霉素敏感率〈50％，对左氧氟沙星、莫昔沙星、青霉素-G敏感率〈10％。结论临床分离的肠球菌以粪肠球菌、屎肠球菌为主，屎肠球菌对四环素敏感率高于粪肠球菌，屎肠球菌对多种抗生素较粪肠球菌具有更强的耐药性，粪肠球菌和屎肠球菌对万古霉素敏感率89．8％和91．6％。粪肠球菌、屎肠球菌对万古霉素耐药率6．9％和7．0％。

Susceptibility analysis Enterococcus faecalis and Enterococcus faecium to 9 kinds of commonly-used antibiotics

Objective To study the antimicrobial susceptibility trends of E. faecalis and E. faecium from clinical specimens in our hospital from 2003 to 2006, and to apply clinical suggestions for treating Enterococcus infections. Methods The dates of E. faecalis and E. faecium and its antimicrobial susceptility in recent four years were analyzed retrospectively by VITEK-32 automatic microbial analysis system. Results Of the 432 E. faecalis and E. faecium accounted for 77.0% in all Enterococcus isolates from clinical samples. E. faecalis and E. faecium accounted for 48.8% and 28.2%. The main infectious sites by E. faecalis were not the same as E. faecium. The Enterococcus isolates from urine, secretion with pus and sputum accounted for 46.0%, 31.0% and 18.6% of the E. faecalis and 75.9%, 15.8% and 5.1% of the E. faecium. The susceptibility rates of E. faecalis nitrofurantion, linezolid and vancomycin was more than 90% and to high-level gentamicin, streptomycin, levofloxacin and moxifloxacin was less 50%, The susceptibility rates of E. faecium to linezolid and vancomycin was more than 90% and to tetracycline was 78%-88% and to high-level gentamicin, streptomycin was less 50% and to penicillin-G1 levofloxacin, moxifloxacin was less 10%. Conclusion E. faecalis and E. faecium were the main species in the Enterococcus isolates from clinical samples. The susceptibility rate of E. faecalis to tetracycline was less than E. faecium. E. faecium as compared with E. faecalis resists many antimicrobial agents more strong. The susceptibility rates of E. faecalis and E. faecium to vancomycin were 89.8% and 91.6%. The resistant rates of E. faecalis and E. faecium to vancomycin were 6.9% and 7.0%.