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肠球菌的耐药性监测及临床分析
http://www.100md.com 2010年6月5日 谭贵海,吴钊坤,冯亦伟
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     [摘要] 目的:探讨肠球菌的耐药性监测及临床特点。方法:对我院分离出的86株肠球菌的相关资料进行回顾性分析,总结其耐药性监测及临床特点。结果:肠球菌主要来源于尿液44株(51.2%)、生殖系统分泌物20株(23.3%),其中,粪肠球菌50株(58.1%)、屎肠球菌28株(32.6%)、其他8株(9.3%);药敏结果显示,粪肠球菌对头孢吡肟、阿米卡星、氟氧沙星高度耐药,屎肠球菌对青霉素、氨苄西林、红霉素高度耐药。结论:肠球菌主要来源于尿液、生殖系统分泌物及胆汁,粪肠球菌、屎肠球菌最为多见,临床医师应参考药敏结果选择正确、有效的药物对患者进行治疗。

    [关键词] 粪肠球菌;屎肠球菌;耐药性;药敏试验

    [中图分类号] R969.3[文献标识码] A [文章编号] 1673-7210(2010)06(a)-174-02

    The surveillance and analysis on the drug resistance of enterococcus

    TAN Guihai, WU Zhaokun, FENG Yiwei

    (The People's Hospital of Gaozhou City, Gaozhou 525200, China)

    [Abstract] Objective: To analysis the drug resistance and clinical characteristics of enterococcus. Methods: The related data of 86 cases with enterococcus in our hospital were analyzed retrospectively, and summarized the drug resistance and clinical characteristics of enterococcus. Results: 44 cases (51.2%) were mainly from enterococcus mainly from urine, 20 cases (23.3%) were mainly from reproductive system discharge, among them, 50 cases (58.1%) of enterococcus faecalis, 28 cases (32.6%) of feces enterococcus, 8 cases (9.3%) of other enterococcus; drug sensitivity test results showed that enterococcus faecalis was highly resistant to cefepime, amikacin, fluorine oxygen, enterococcus faecium was highly resistant penicillin, ampicillin and erythromycin. Conclusion: Enterococcus are mainly from urine, reproductive system discharge and bile secretion, enterococcus faecalis and enterococcus faecium are most prevalent, clinicians should refer to the drug sensitivity test results to choose the right and effective drug for the treatment of patients.

    [Key words] Enterococcus faecalis; Enterococcus faecium; Drug resistance; Drug sensitivity test

    肠球菌属细菌为条件致病菌,可以引起人体多种组织脏器的严重感染。近年来肠球菌属细菌所致的感染有不断增加的趋势,已成为医院感染的重要致病菌[1],而且,从临床标本分离的肠球菌属细菌中有许多为多重耐药菌株,给临床治疗带来了很大的困难[2]。笔者探讨我院肠球菌的耐药性监测及临床特点,以期为临床工作提供指导。

    1 资料与方法

    1.1 一般资料

    本研究中的86株肠球菌分离于我院2009年3~8月门诊和住院患者送检的痰液、尿液、生殖系统分泌物、血液及胆汁等标本。

    1.2 检测方法

    质控菌株为金葡菌ATCC 25923和粪肠球菌ATCC 29212,M-H 琼脂购自北京天坛生物制品研究所。药敏纸片青霉素、氨苄西林、替考拉宁、庆大霉素、阿米卡星、米诺环素、氧氟沙星、环丙沙星、红霉素、万古霉素、阿奇霉素均为中国药品生物制品检定所产品,操作及结果判定严格参照NCCLS(2002年版)标准。

    2 结果

    2.1 86株肠球菌主要来源

    86株肠球菌来源于痰液6株(7.0%)、尿液44株(51.2%)、生殖系统分泌物20株(23.3%)、血液7株(8.1%),胆汁7株(8.1%),其他标本2株(2.3%)。

    2.2 86株肠球菌的耐药性监测

    86株肠球菌中,粪肠球菌50株(58.1%)、屎肠球菌28株(32.6%)、其他8株(9.3%);药敏结果显示,粪肠球菌对头孢吡肟、阿米卡星、氟氧沙星高度耐药,屎肠球菌对青霉素、氨苄西林、红霉素高度耐药,其他菌株耐药性较低。见表1。

    表1 86株肠球菌药敏试验耐药率总结[n(%)] ......

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