2014-2017年某医院152例尿路感染肠球菌耐药性监测分析

目的:了解2014年1月-2017年1月某医院尿液标本分离肠球菌的临床特点及耐药情况,为肠球菌经验治疗提供参考依据。方法:回顾性分析2014年1月-2017年1月分离自尿液标本肠球菌,VITEK2-compact微生物鉴定系统对细菌进行鉴定,纸片扩散法联合MIC法行抗生素敏感试验,WHONET 5.6和SPSS 20软件进行统计分析。结果:(1)2014年1月-2017年1月尿液标本共检出病原菌908株,主要是大肠埃希菌,其中屎肠球菌84株,粪肠球菌68株,是位于第2位和第3位的病原菌。(2)屎肠球菌对于氨苄西林、高水平庆大霉素、环丙沙星、左氧氟沙星、呋喃妥因的耐药率分别89.6%,63.2%,91.5%,85.7%,69.4%、明显高于粪肠球菌的24.2%(2=65.001,P=0.000)、40.4%(2=8.246,P=0.004)、56.6%(2=26.129,P=0.000)、51.2%(2=21.144,P=0.000)、12.2%(2=50.193,P=0.000);粪肠球菌对于氯霉素的耐药率为33.3%,显著高于屎肠球菌2.6%(2=27.035,P=0.000)。二者对于喹诺酮类抗生素都有较高的耐药率(51.2%)。(3)检出一株对万古霉素耐药的屎肠球菌,耐药率为1.2%(1/84);未检出对万古霉素耐药的粪肠球菌;未发现对利奈唑胺、替加环素耐药的肠球菌。(4)屎肠球菌多重耐药现象严重。结论:尿液标本屎肠球菌与粪肠球菌对抗菌药物耐药性差异大,屎肠球菌多重耐药现象形势严峻,已发现耐万古霉素的屎肠球菌,必须严密监控,尽早诊治,切断传播链。

Analysis of drug resistance of 152 Enterococcus from a hospital in Inner Mongolia Baotou from 2014 to 2017

OBJECTIVE To investigate the drug resistance of Enterococcus from a hospitals in Inner Mongolia Baotou from 2014 to 2017,provide evidence for clinical use of antibiotics.METHODS Enterococcus of clinical specimens from urine was identified by the VITEK2-compact system,the K-B and MIC method were used for antimicrobial susceptibility testing,WHONET5.6 and SPSS 20 were used for data processing to analyze the resistance of Enterococcus.RESULTS A total of 152 strains of Enterococcus spp.were isolated,including E.faecium 84 and E.faecalis 68.The resistance rates of E.faecium to ampicillin,gentamicin (high concentration), ciprofloxacin,levofloxacin,nitrofurantoin were 89.6%,63.2%,91.5%,85.7%,69.4%,higher than those of E.faecalis of 24.2%,40.4%,56.6%,51.2%,12.2%.However,the resistance rate of E.faecium to chloramphenicol was significantly lower than that of E.faecalis.The resistance rates of them to quinolone drugs were high (51.2%).The resistance rate of E.faecium to vancnmycin was 1.2% (1/84),68 strains of E.faecalis were all sensitive to vancomycin.There was no Enterococcus of linezolid resistance or tigecycline resistance.E.faecium was highly multidrug resistant.CONCLUSION There are significantly varied drug resistance of E.faecium and E.faecalis,so attentions should be paid to surveillance of Enterococcus.Additionally,it is imperative to enhance control and prevention of VRE.