2001年湖北地区381株肠球菌的耐药性分析

目的 研究肠球菌的临床分布特征，并测试其对美国临床实验室标准化委员会（NCCLS）推荐抗生素的敏感性，以便合理用药。方法 对湖北地区2001年1月-12月间分离出的381株肠球菌进行纸片扩散法药敏试验和β-内酰胺酶测定。结果 381株肠球菌中粪肠球菌占78.0%，屎肠球菌占19.4%，坚忍肠球菌占1.6%，鸟肠球菌占0.53%，空肠肠球菌与孤独肠球菌各占0.3%，产β-内酰胺酶的肠球菌占3.2%，在检出肠球菌的标本中源于泌尿道中和生殖道占首位，为46.5%，可能与部分资料来源于泌尿专科医院有关；其次为呼吸系统，占35.4%，对抗生素的耐药率由低到高依次为：万古霉素（5.8%)，替考拉宁（7.9%)，呋喃妥因（11.0%)，氨苄西林（24.7%)、青霉素（26.8%)，环丙潲星（38.6%)，氯霉素（54.6%），高浓度庆大霉素（54.6%)，高浓度链霉素（52.5%)，四环素（79.3%)。结论 分离出的肠球菌中以粪肠球菌，屎肠球菌为主；检出肠球菌的标本中主要来源于泌尿生殖系统及呼吸系统；屎肠球菌的耐药性明显高于粪肠球菌，万古霉素对肠球菌的耐药性最低。

Analysis on drug-resistance of 381 strains of enterococci isolated from Hubei in 2001

Objectives To study the characteristics of clinical distribution of enterococci, to test its sensitivity to antibiotics recommended by NCCLS, and to promote rational use of antibiotics. Methods A total of 381 strains of enterococci isolated from Hubei during January to December 2001 were tested for their sensitivity to antibiotics and production of beta-lactamases with paper disk diffusion method. Results Among 381 strains of enterococci, there were 78.0% of E. faecalis, 19.4% E. faecium, 1.6% E. durans, 0.53% E. avium, 0.3% E. hirae and 0.3% E. solitarium , and beta-lactamases-producing enterorocci accounted for 3.2% of the total. And, 46.5% of the strains were isolated from uroreproductive tracts samples, ranking the first of the total, possibly because of some samples from a hospital specialized in urology, 35.4 % from respiratory tract, ranking the next, and 11.0% form skin pustule and infected wound, ranking the third. Proportions of the strains resistant to varied antibiotics were 5.8%, 7.9%, 11.0%, 24.7%, 26.8%, 38.6%, 54.6%, 54.6%, 52.5% and 79.3% to vancomycin, teicoplanin, nitrofurantoin, ampicillin, penicillin, ciprofloxacin, chloromycetin, high concentration gentamycin, high concentration streptomycin, and tetracycline, respectively. Drug-resistant rate of E. faecium was higher than that of E. faecalis. Conclusions Enterococci, most of them identified as E. faecalis and E. faecium, were isolated from samples of uroreproductive and respiratory system, and the most susceptible to vancomycin. E. faecium was more resistant to antibiotics than E. faecalis.