1012株粪肠球菌对14种抗菌药物的耐药性分析

与人类疾病有关的肠球菌中,粪肠球菌(entero- coccus faecalis,EF)因其易定植、易变异、耐药机制复杂等特性,已逐渐成为医院感染的主要致病菌之一。为了解近年来EF对抗菌药物的耐药性变化,进一步指导临床合理用药,我们分析了2001-2005年EF对临床常用的14种抗菌药物的耐药情况。     

粪肠球菌和屎肠球菌的耐药性分析

目的了解粪肠球菌和屎肠球菌对抗感染药物的耐药性,为临床提供治疗依据。方法对住院及门诊患者送检样本中培养分离出281株肠球菌（粪肠球菌112株,屎肠球菌169株）的感染分布与耐药情况进行分析。采用稀释法进行药物敏感试验,结果按美国临床实验室标准化研究所标准判定。结果屎肠球菌对青霉素G的耐药率最高（93．7％）,其次为红霉素、氨苄西林和环丙沙星。粪肠球菌对奎奴普丁／达福普汀耐药率最高为（74．0％）,其次为高浓度庆大霉素、四环素、红霉素和环丙沙星。粪肠球菌和屎肠球菌对利奈唑胺和万古霉素的耐药率均低于2．0％,替考拉宁的耐药率最低（均为0）。结论粪肠球菌和屎肠球菌对不同抗感染药物的耐药率有较大差异,在抗感染治疗前应先做细菌培养和药物敏感试验,依据报告结果合理选用抗感染药物。     

粪肠球菌和屎肠球菌的耐药性回顾性分析

目的了解粪肠球菌和屎肠球菌对抗菌药物的耐药动态.方法对2004年国内公开发表的14种医学期刊所刊登的同时有关肠球菌和屎肠球菌耐药性分析文章16篇,进行了回顾性分析.结果粪肠球菌5093株,占77.5%;屎肠球菌1456株,占22.5%.粪肠球菌和屎肠球菌对15种抗菌药物具有不同的耐药性,并显现出多重耐药现象.对万古霉素、替考拉宁的耐药率最小,均小于3%;对青霉素G、氨苄青霉素、左氧氟沙星、氟哌酸的耐药率两者有极显著差异;对克林霉素的耐药率最高,达97%以上.结论随着抗菌药物的广泛运用,耐药现象日益严重,粪肠球菌和屎肠球菌的耐药率显著提高,为避免耐药菌的产生最根本的途径是合理使用抗菌药物.     

肠球菌属细菌对抗菌药物的耐药性分析

目的了解肠球菌对常用抗菌药物的耐药性特点。方法对临床标本中分离出的细菌进行系统检验,采用K-B纸片法对分离鉴定后的肠球菌进行药物敏感性试验。结果屎肠球菌对青霉素类、呋喃妥因、喹诺酮类、高浓度庆大霉素、红霉素和利福平的耐药性明显高于粪肠球菌,而对四环素类抗菌药物、高浓度链霉素和氯霉素的耐药性则低于粪肠球菌;万古霉素和替考拉宁是敏感性最高的抗菌药物。结论临床医师应关注临床常见病原菌的耐药性,动态监测肠球菌的耐药状况对于指导临床治疗具有重要意义。     

粪肠球菌耐药性检测及分析

目的了解粪肠球菌对常用抗菌药物的耐药情况．指导临床合理用药。方法对临床分离出的51株粪肠球菌，使用琼脂稀释法进行药敏试验并对结果进行分析。结果51株粪肠球菌标本来源依次为尿液50．9％、外科分泌物19．6％、痰17．7％，51株粪肠球菌对万古霉素、替考拉宁、利奈唑胺的耐药率为0：对磷霉素、高浓度链霉素的耐药率较低，分别为25．5％和39．2％；而对其他临床常用抗菌药物耐药率均超过50％。结论粪肠球菌多重耐药显著，而对糖肽类和利奈唑胺十分敏感。     

50株肠球菌体外抗菌药物耐药性结果分析

目的:了解临床分离50株肠球菌对10种抗菌药物活性状况,合理指导临床使用抗生素、提高治疗效果、减少耐药菌株的产生。方法:对临床分离出50株肠球菌进行生化鉴定和抗生素体外敏感试验。结果:50株肠球菌中,粪肠球菌44株(占88%),屎肠球菌5株(占10%),鸟肠球菌1株(占2%)。庆大霉素高浓度耐药株(HLAR)共分离出36株(72%),耐万古霉素肠球菌(VER)1株(2%)结论:抗菌药物的不合理的应用和侵入性的治疗机会增加导致肠球菌感染率增高,尤其是对氨苄西林耐药株和庆大霉素耐药株有逐渐增加的趋势,故在治疗肠球菌感染的疾病时应根据分离株自身的耐药特点来决定治疗方案。     

肠球菌医院感染的特征及其对新型抗菌药物的耐药性分析

目的:分析肠球菌医院感染的特征及其对新型抗菌药物的耐药性。方法:抽取2016年2月—2017年6月间临床送检标本中检出医院感染的肠球菌属细菌160株资料,统计这些菌株的细菌分离培养、鉴定以及药敏试验结果,分析肠球菌医院感染的特征以及对抗菌药物的耐药性。结果:160株肠球菌中,尿液标本检出率为最高(58.13%),其中以粪肠球菌(55.00%)与屎肠球菌(37.50%)为主;屎肠球菌对青霉素、红霉素、利福平、氨苄西林、环丙沙星和左氧氟沙星的耐药率均大于75.00%,粪肠球菌除对红霉素、四环素、利福平外的耐药率均低于25.00%(P<0.05);粪肠球菌与屎肠球菌对万古霉素的耐药率为0,而对利奈唑胺的耐药率前者为1.14%,后者为0;两种菌株对高浓度庆大霉素与高浓度链霉素的耐药率均大于40.00%(P>0.05);在四环素和喹奴普丁/达福普丁的耐药率观察,粪肠球菌分别为72.73%和100.00%,屎肠球菌分别为43.33%和18.33%。结论:肠球菌主要存在于尿液标本中,其中属粪肠球菌与屎肠球菌为最常见,而两者对于各类抗菌药物皆具有不同程度的耐药性,因此临床应根据致病菌株的耐药特点,合理选用抗菌药物。     

肠球菌属耐药机制与新抗菌药物研究进展

<正> 肠球菌属细菌为条件致病菌,可以引起人体多种组织脏器的严重感染。近年来肠球菌属细菌所致感染有不断增加的趋势,已成为医院感染的重要致病菌。而且从临床标本分离的肠球菌属细菌中有许多为多重耐药菌株,特别是氨基糖苷类高水平耐药肠球菌(HLAR)以及耐万古霉素肠球菌(VRE)的出现,给临床治疗带来了很大的困难。现将肠球菌属耐药机制与新抗菌药物研发进展阐明如下。1 肠球菌属细菌耐药性的流行病学与耐药机制     

某院肠球菌属耐药性变迁及其与抗菌药物使用的相关性研究

目的：分析医院肠球菌属的检出情况和耐药变迁,以及其与抗菌药物使用的相关性,为临床治疗肠球菌属感染提供参考。方法：收集2015年1月—2019年12月玉林市中西医结合骨科医院收治的微生物培养结果为肠球菌属的住院患者的病历资料,统计肠球菌属的标本来源和历年的耐药情况,采用Pearson相关性分析法分析肠球菌属的耐药变化与抗菌药物使用的相关性。结果：2015年1月—2019年12月,医院住院患者标本中共分离出肠球菌属593株,其中粪肠球菌510株（占86.00%）、屎肠球菌83株（占14.00%）;粪肠球菌以从分泌物标本中检出为最多（418株,占81.96%）,屎肠球菌则主要检出自分泌物（44株,占53.01%）和尿液（37株,占44.58%）;5年间,粪肠球菌和屎肠球菌对万古霉素、替加环素的耐药率始终较低（<10.00%）,粪肠球菌对呋喃妥因的耐药率亦始终较低（<10.00%）,屎肠球菌则对利奈唑胺的耐药率始终较低（<10.00%）;粪肠球菌对青霉素、环丙沙星、左氧氟沙星、利奈唑胺的耐药率相对较低（<30.00%）,但对青霉素的耐药率逐年下降,对利奈唑胺的耐药率则逐...     

Influence of adjunctive interferon-gamma on treatment of gentamicin- and vancomycin-resistant Enterococcus faecalis infection in mice.

Increasing antibiotic resistance and the development of multidrug-resistance in the enterococci has complicated the treatment of serious enterococcal infections. It has been demonstrated in vitro that interferon-gamma (IFN-γ) significantly augments the activities of gentamicin and vancomycin against Enterococcus faecalis resistant to these antibiotics. The present study was aimed at determining whether this beneficial effect of IFN-γ on antienterococcal antibiotic activity can be validated in vivo. Following intraperitoneal inoculation in mice with a gentamicin- and vancomycin-resistant E. faecalis clinical isolate, the animals received IFN-γ, antibiotic or a combination of both agents, subcutaneously, at determined dosing regimens. Treatment with IFN-γ alone significantly improved survival of infected animals in a dose-dependent manner. High dose IFN-γ was not beneficial and the level of enterococcal infectious burden influenced the effectiveness of the cytokine. The addition of IFN-γ to therapy with gentamicin or vancomycin, or a combination of both antibiotics was associated with a marked increase in survival of infected non-neutropenic mice compared to treatments with the agents alone. However, the same treatments made in infected neutropenic mice did not show an enhancement effect by IFN-γ after a combination therapy with antibiotics. In a study to examine pharmacokinetic interactions, concurrent administration with IFN-γ significantly modified the disposition of gentamicin but not that of vancomycin. The results of this study suggest that the use of IFN-γ in combination with vancomycin or gentamicin is a new treatment option that might improve the outcome of therapy of multidrug-resistant E. faecalis infections.     

A case report of vancomycin-resistant Enterococcus faecalis colonization of a femoral wound in central europe

Wound infection and colonization following cardiac surgery is well known but rarely caused by vancomycin-resistant enterococci (VRE). A case of femoral wound colonization by vanA carrying Enterococcus faecalis in a patient following mitral prolapse surgery is described in this report.     

Effect of sonodynamic action of hypocrellin B on biofilm-producing Enterococcus faecalis

OBJECTIVE To investigate the effect of sonodynamic action on biofilm-producing Enterococcus faecalis using hypocrellin B from a natural product Hypocrella bambuase as a sensitizer.METHODS The uptake of hypocrellin B in biofilm-producing Enterococcus faecalis was measured using the fluorescent analysis method.After the combined treatment of hypocrellin B and ultrasound,the growth of biofilm-producing Enterococcus faecalis was measured using the colony counting method,the membrane integrity was detected using a flow cytometric analysis with propidium iodide staining.Chromosomal DNA of bacteria was analysed using apulsed-field gel electrophoresis(PFGE).RESULTS The uptake of hypocrellin B in biofilm-producing Enterocuccus faecalis reached a high peak at the 20 min incubation.After the combined treatment of hypocrellin B,the growth of biofilm-producing Enterocuccus faecalis significantly descreased and membrane integrity was remarkably damaged.However,no remarkable change in bacterial DNA was found.CONCLUSION Sonodynamic action of hypocrellin B had significant killing activity on Enterocuccus faecalis.     

粪肠球菌EF608饲喂小鼠的安全性研究

目的研究本实验室发现的新型菌株——粪肠球菌EF608(Enterococcus faecalis EF608)的安全性,为进一步开发提供实验依据。方法经腹腔注射和口腔灌胃两种途径给小鼠粪肠球菌EF608菌株,试验其安全性。结果灌胃组与腹腔注射组,小鼠均健康存活,体重均有增加;小鼠脏器无明显变化,脏器系数与各自对照组比较均无显著差异(P>0.05)。结论粪肠球菌EF608菌株对小鼠安全无毒。     

Cerebrospinal fluid concentrations of quinupristin-dalfopristin in a patient with vancomycin-resistant Enterococcus faecium [correction of faecalis] ventriculitis

A 44-year-old man was treated successfully for vancomycin-resistant Enterococcus faecium (VREF) ventriculitis with intrathecal quinupristin-dalfopristin 1 mg, 2 mg, and 4 mg, and other intravenous antibiotics. Cerebrospinal fluid samples were collected before and after the 1-mg and 2-mg doses to determine the concentrations of quinupristin-dalfopristin and its active metabolites. Concentrations were above the minimum inhibitory concentration for VREF immediately after unclamping the extraventricular drain and were quantifiable for at least 7 hours.     

In vitro activity of phenothiazine derivatives in Enterococcus faecalis and Enterococcus faecium

The antimicrobial activity of the phenothiazine derivatives thioridazine and prochlorperazine have been evaluated with 11 Enterococcus faecalis strains and 9 Enterococcus faecium strains, originating from human infections and animal faecal flora. We found that all E. faecalis and E. faecium strains, regardless of their susceptibility to commonly used antibiotics, were inhibited by thioridazine at a concentration of 16-32 microg/ml and by prochlorperazine at a concentration of 32-64 microg/ml. Combinations of the antibiotics vancomycin or ampicillin and thioridazine and prochlorperazine at subinhibitory concentrations, could render vancomycin- or ampicillin-resistant bacteria sensitive to each of the antibiotics. Verapamil and reserpine, inhibitors of P-glycoprotein-mediated multidrug resistance, did not reduce resistance. Our results outline modification of resistance in enterococci induced by phenothiazine derivatives unrelated to P-glycoprotein-mediated multidrug resistance.     

银杏酸C17:1衍生物增效达托霉素抗粪肠球菌的发现与机制的初步研究

目的 发现有抗菌活性或是增效活性的银杏酸C17:1衍生物。方法 以银杏酸C17:1为底物，利用一些基团取代苯环上的羧基从而获得银杏酸C17:1衍生物，棋盘法设计试验，测定银杏酸C17:1及其衍生物联合抗生素的增效作用，通过测定Zeta电位、ROS、NPN吸收来探究增效机制。结果 银杏酸C17:1衍生物Ⅱ与达托霉素联合抗粪肠球菌的部分抑菌浓度指数(FICIs)为0.125~0.25，具有明显的协同效应，不仅能产生较高的活性氧，而且能在一定程度改变细胞膜的通透性。结论 银杏酸衍生物Ⅱ对达托霉素体外抗耐药株具有较好的增效作用，可能和ROS的激增以及膜通透性的改变有关。