HLGR肠球菌的检测及肠球菌耐药性变迁的分析

目的了解高水平庆大霉素耐药(HLGR)的肠球菌的检出情况及肠球菌耐药性变迁。方法采用纸片扩散法(K-B法)抗生素敏感试验检测1999—2000年和2003—2004年两个时期从临床标本中分离出的肠球菌。结果在1999—2000年间，庆大霉素高水平耐药肠球菌的检出率是40．0％(16／40)，肠球菌对红霉素、四环素、利福平、氯霉素、氨苄西林、氧氟沙星、呋喃妥因的耐药率分别是65．0％(26／40)、70．0％(28／40)、55．0％(22／40)、42．5％(17／40)、7．5％(3／40)、27．5％(11／40)、0，未检出万古霉素耐药的肠球菌。在2003～2004年间。庆大霉素高水平耐药肠球菌的检出率是50．0％(30／60)，肠球菌对上述相应抗生素的耐药率分别是80．0％(48／60)、61．7％(37／60)、55．0％(33／60)、38．3％(23／60)、53.3％(32／60)、51．7％(31／60)、8．3％(5／60)，检出1株耐万古霉素的肠球菌(占1．7％)。结论随着时间的推移，本地区HLAR肠球菌的检出率在逐渐增加。肠球菌对临床常用抗生素的耐药率除四环素、利福平和氯霉素外，其余均呈增加趋势，万古霉素仍是治疗肠球菌感染的有效药物。临床上治疗肠球菌引起的感染，必须根据分离株的耐药特点选择合适的抗生素。

Surveillance of High-Level Gentamicin Resistance in Enterococcus spp and the Changes of Antibiotic Resistance of Enterococci

Objective To study the high-level gentamicin resistance(HLGR) rate in Enterococcous spp and the changes of antibiotic resistance of Enterococci. Method The antibiotics resistance of Enterococci isolated during 1999-2000 and 2003-2004 were detected with disc agar diffusion method. Results During 1999-2000 and 2003-2004,the detection rate of high-level gentamicin resistance in Enterococci were 40.0%(16/40) and 50.0%(30/60) respectively;the resistance rate to erythromycin,tetracycline,rifampicin, chloramphenicol, arapicillin, ofloxacin and nitrofurantoin were 65.0%(26/40), 70.0%(28/40), 55.0%(22/40), 42.5%(17/40), 7.5%(3/40), 27.5%(11/ 40),0 and 80.0%(48/60), 61.7%(37/60), 55.0%(33/60), 38.3%(23/60), 53.3%(32/60), 51.7%(31/60), 8.3%(5/60) respectively.The vacomycin-resistant Enterococci were not detected during 1999-2000, but the vacomycin-resistant rate of Enterococci was 1.7% (1/60) during 2003-2004. Conclusions The detection rate of high-level gentamicin resistance in Enterococcus spp was increasing gradually from 1999 to 2004. The resistance rate of Enterococci to the commonly used antibiotics was increasing except for tetracycline, rifampicin and chloramphenicol. Vacomycin was still effective antibiotic for treating Enterococci infection.