临床分离肠球菌分布及其耐药性监测

目的 了解某院临床分离肠球菌的菌群分布及其耐药情况。方法 采用全自动微生物分析仪VITEK AMS 32对分离自各类临床标本的206株肠球菌进行鉴定及药敏试验，并对耐万古霉素的菌株用K—B法作进一步验证。结果 206株肠球菌中，以粪肠球菌(80．10％)和屎肠球菌(11．65％)为主。菌株来源以痰液(21．84％)、前列腺液(20．87％)、脓液(20．39％)、尿液(10．68％)为主。耐万古霉素肠球菌(VRE)中，粪肠球菌为1．82％，屎肠球菌为4．17％，鸟肠球菌为14．29％，鸡肠球菌为100％。粪肠球菌中高浓度庆大霉素耐药株(HLGR)占56．36％，高浓度链霉素耐药株(HLSR)占54．55％；屎肠球菌中HLGR为79．17％，HLSR为45．83％。结论 肠球菌所致感染以下呼吸道医院感染占首位。各菌种对抗菌药物的敏感率相差较大，微生物室必须做好菌种鉴定及药敏试验，以指导临床合理用药。

Distribution of Enterococcus isolated from clinic samples and surveillance of antimicrobial resistance

Objective To evaluate the distribution of Enterococcus isolated from clinical samples and bacterial resistance to antimicrobial agents. Methods Two hundred and six strains of Enterococcus were isolated, identification and antimicrobial susceptibility tests were performed. Results The majority of 206 strains of Enterococcus were E.faecalis ( 80.10% ) and E.faecium ( 11.65% ), strains were mainly isolated from sputum ( 21.84% ), prostatic fluid (20.87%) ; pus ( 20.39% ) and urine (10.68%) . The isolation rate of vancomycin resistant strains of E.faecalis, E.faecium, E.avium and E.gallinarum were 1.82% , 4.17% , 14.29% and 100%, respectively. Among strains of E.faecalis, 56.36% and 54.55% were highly resistant to gentamycin and streptomycin respectively; and among strain of E.faecium, 79.17% and 45.83% were highly resistant to gentamycin and streptomycin respectively. Conclusion The main nosocomial infection caused by Enterococcus are lower respiratory infection, there are significant differences in antimicrobial susceptibilily among different species, the correct identification and antimicrobial susceptibility tests of strains ought to be performed to provide reference for rational antimicrobial application in clinic.