2396株肠球菌属细菌的临床分布及耐药性变迁

摘要：目的 探讨2396株肠球菌属细菌的临床分布特点及耐药情况，为临床抗感染工作提供有力的参考依据。方法 回顾性分析本院2015-2020年住院患者临床分离的肠球菌资料，梳理出肠球菌临床分布及对不同抗菌药物的耐药情况，运用统计学方法分析并总结。结果 2396株肠球菌中屎肠球菌874株，粪肠球菌1204株，鹑鸡肠球菌123株，铅黄肠球菌76株，鸟肠球菌70株；分离标本来自于尿液1070株(占44.65%)，胆汁747株(占31.17%)，引流液263株(占10.97%)；2396株肠球菌在外科共检出1662株(占69.36%)，内科462株(占19.28%)。屎肠球菌对利奈唑胺、喹努普汀/达福普汀耐药率低于10%；对替加环素、替考拉宁、万古霉素耐药率低于5%；高浓度庆大霉素、高浓度链霉素耐药率(P<0.001)均呈现逐年下降趋势。粪肠球菌对环丙沙星、氨苄西林耐药率低于23%；铅黄肠球菌对呋喃妥因耐药率均低于5%。粪肠球菌对四环素、喹努普汀/达福普汀的6年整体耐药率高于屎肠球菌。结论 检出2396株肠球菌以屎肠球菌和粪肠球菌为主，主要来自尿液、胆汁和引流液。6年来粪肠球菌对临床常用抗菌药物的耐药率明显低于屎肠球菌，利奈唑胺、替加环素及万古霉素耐药菌已出现，应引起重视，督促临床合理选择抗菌药物。

Clinical distribution and antibiotic resistance of 2,396 Enterococcus isolates

Abstract Objective To analyze the clinical distribution and antibiotic resistance of 2,396 strains of Enterococcus bacteria, and to provide a powerful reference for clinical work. Methods A retrospective data analysis of Enterococcus isolates from our hospital was conducted, and then statistical analysis was performed. Results 2,396 strains of Enterococcus included E. faecium(874), E. faecalis(1204), E. gallinarum(123), E. casselifavus(76), and E. avium(70). The isolates were mainly from urine(44.65%, 1,070/2,396), bile(31.17%, 747/2,396), and drainage liquid(10.97%, 263/2,396). They were from different clinical departments, including surgery(69.36%, 1,662/2,396) and internal medicine(19.28%, 462/2,396). The resistance rate of E. faecium to linezolid, quinuptin/dafoptin was less than 10%, to tigacycline, teicolanin, and vancomycin was less than 5%; The resistance rate to high-level gentamicin and high-level streptomycin ((P<0.001) showed a decreasing trend year by year. The resistance rate of E. faecalis to ciprofloxacin and ampicillin was less than 23%. The resistance rate of E. casselifavus to furantoin was less than 5%. The 6-years overall resistance rate of E. faecalis to tetracycline and quinupratin/dafoptin was higher thanE. faecium. Conclusion 2,396 strains of Enterococcus were mainly E. faecalis and E. faecium, which were mainly from urine, bile, and drainage fluid. The resistance rate of E. faecalis was significantly lower than E. faecium. Linezolid, tigecycline, and vancomycin warns us to pay attention to the situation of bacterial resistance, and to supervise clinical rational selection of antimicrobial