尿路感染肠球菌的耐药性分析及临床分布特点

目的 了解引起尿路感染的肠球菌对常用抗菌药物的耐药情况,及其临床分布特点,为临床治疗肠球菌性尿路感染提供参考依据。 方法 对我院2008年1月至2012年12月间临床尿培养检出的肠球菌进行鉴定,采用K-B纸片扩散法进行药敏试验,用WHONET 5.6软件对药敏结果进行统计分析,用Excel表对患者的临床分布特点进行分析。 结果 从临床尿路感染患者中分离出的111株肠球菌中,屎肠球菌61株(55.0%),粪肠球菌47株(42.3%),其他种类肠球菌3株(2.7%)。药敏结果显示引起尿路感染的肠球菌对临床常用抗菌药物耐药严重,耐药率最低的是万古霉素。屎肠球菌对大多数抗菌药物的耐药率要明显高于粪肠球菌,但是氯霉素和四环素例外。肠球菌引起的尿路感染以50岁以上的患者为主,占86.5%;感染最多见于泌尿外科病房和重症医学科,分别占26.1%和22.5%。 结论 肠球菌已成为尿路感染的重要病原菌,屎肠球菌的比率已超过粪肠球菌,不同种类的肠球菌耐药性差别大,应加强对重点人群的监测和管理,并根据药敏结果、感染的严重程度合理选择适当的抗菌药物。

Antibiotic resistance and clinical distribution of Enterococci isolated from urine samples of patients with urinary tract infections

Objective To understand the antibiotic resistance and clinical distribution of Enterococci isolated from urine samples of patients with urinary tract infections and provide evidence for the treatment of urinary tract infection caused by Enterococcus. Methods Enterococcus strains were isolated from urine samples of patients with urinary tract infections in our hospital from January 2008 to December 2012. The antibiotic susceptibility test was carried out with Kirby-Bauer (KB) method. Data were analyzed with WHONET 5.6 software and Excel. Results A total of 111 Enterococcus strains were isolated, among which 61 were Enterococcus faecium strains (55.0%), 47 were Enterococcus faecalis strains (42.3%), 3 were other Enterococcus strains (2.7%). The drug susceptibility results showed that the resistance of the Enterococcus strains was serious, the resistant rate to vancomycin was lowest. The resistant rates of E. faecium strains to most antibiotics tested were higher than those of E. faecalise strains except chloramphenicol and tetracycline. Up to 86.5% of the patients with Enterococcus infections in urinary tracts were aged over 50 years, and most of them were hospitalized in urinary surgery department and ICU, accounting for 26.1% and 22.5% respectively. Conclusion Enterococcus has become an important pathogen to cause urinary tract infection, and E. faecium was predominant. The resistance of different Enterococci varied. The surveillance should be strengthened in risk population and antibiotics should be used according to their drug susceptibility.