【作者】 储从家； 吴惠玲； 李杰芬；

【Author】 CHU Cong-jia;WU Hui-ling;LI Jie-fen;People’s Hospital of Yuxi City;

【机构】 玉溪市人民医院检验科；

【摘要】 目的了解某院肠球菌的菌种分布及耐药谱分析,为临床用药提供依据。方法对某院2013年1月至12月临床各科室送检的各类标本中培养分离出的441株肠球菌作回顾性分析。结果441株肠球菌属细菌含8个种,以屎肠球菌最多,占51.02%(225/441),粪肠球菌次之,为38.55%(170/441),其余菌种较少均小于3%。以体液样本分离菌数最多,占46.26%(204/441),其次为尿液32.88%(145/441),第三位为口痰14.06%(62/441)。分离数居前3位的科室依次为普外科107株占24.26%,重症医学科78株占17.69%和儿内科31株7.03%。屎肠球菌和粪肠球菌除对高水平庆大霉素、高水平链霉素和克林霉素耐药率差异无显著性外,对青霉素、氨苄西林、环丙沙星、左氧氟沙星、莫西沙星、红霉素、呋南妥因和四环素的耐药率差异有非常显著意义(P<0.01),且除四环素外均为屎肠球菌耐药率显著高于粪肠球菌;未发现耐万古霉素、利奈唑胺和替加环素的屎肠球菌和粪肠球菌。粪肠球菌对青霉素、氨苄西林、环丙沙星、左氧氟沙星、莫西沙星、呋南妥因耐药率均小于30%。屎肠球菌耐药率较高,小于30%的有奎奴普汀/达福普汀和呋南妥因。结论肠球菌为医院感染的主要条件致病菌,不同种的肠球菌对抗生素的耐药有差异性,且多重耐药现象严重,应定期监测细菌变迁和耐药性变化,指导临床合理用药。更多还原

【Abstract】 objective Know bacteria distribution of Enterococcus and Analysis of drug-resistant spectrum in a hospital,and Provide the basis for clinical medication.Methods Do retrospectively analysis for the 441 strains Enterococcus were cultured and isolated from all kinds of specimens which came from different clinical department between January 2013 and December in a hospital.Results 441 strains Enterococcus bacteria including 8 species,and Enterococcus faecium was the most accounted for 51.02%(225/441);the second was Enterococcus faecalis accounted for38.55%(145/441);The remaining species were less than 3%.The isolated bacteria of fluid sample was the most,accounting for 46.26%(204/441);the urine was Followed,accounted for 32.88%(145/441);The third was Koutan,accounting for 14.06%(62/441).The departments of the number of Separation in the top three was general surgery 107 strains were accounted for 24.26%,ICU78 strains were accounted for 17.69%and pediatric 31 strains were accounted for 7.03%.Enterococcus faecium and Enterococcus faecalis in addition to high levels of gentamicin,streptomycin,and a high level of resistance to clindamycin have no significant difference in drug-resistance rate,which have very significant(P <0.01)for Penicillin,ampicillin,ciprofloxacin,levofloxacin,moxifloxacin,erythromycin resistance rate differences Nitrofurantoin and tetracycline.In addition to tetracycline,the drug-resistance rate of Enterococcus faecium was significantly higher than Enterococcus faecalis,the Enterococcus faecium and Enterococcus faecalis of vancomycin,linezolid and tigecycline have n’ t been found.Enterococcus faecalis for drug-resistance rate of penicillin,ampicillin,ciprofloxacin,levofloxacin,moxifloxacin,Nitrofurantoin were less than 30%.The drug-resistance rate of Enterococcus faecium is higher,quinupristin / dalfopristin and Nitrofurantoin were less than30%.Conclusion Enterococcus is the main condition pathogens of nosocomial infection,different species of enterococcus have differences on antibiotic resistance,And multi-drug resistance is serious,we should regularly monitor bacterial changes and drug-resistance changes to guide clinical rational drug use.更多还原