肠球菌致尿路感染的现状研究

目的 监测肠球菌在住院患者尿路感染中的地位及耐药性,为临床疾病防控和用药提供切实可行的方法.方法 采用回顾性分析,对近年医院尿路感染患者进行调查研究.结果 尿液培养分离的2 193株病原菌中,肠球菌占11.8％,其中以粪肠球菌为主,占59.7％,屎肠球菌占39.1％,鹑鸡肠球菌占1.2％;在耐药性方面,体外药敏试验显示两种肠球菌表现各异,屎肠球菌对抗菌药物的敏感性普遍比粪肠球菌高,但是两种肠球菌对糖肽类及替加环素都表现出100％的敏感.结论 院内尿路感染患者中11.8％是由肠球菌引起,仅次于大肠埃希菌占第二位;肠球菌对抗生素的耐药性较严重,临床在治疗尿路感染时应合理选用药物.     

香菇多糖对溃疡性结肠炎大鼠肠道微生态失调的调整作用研究

目的研究香菇多糖通过扶植肠道正常菌群生长,控制内毒素易位,对溃疡性结肠炎大鼠肠道微生态失调进行调整,从微生态学角度防治溃疡性结肠炎。方法 Wistar大白鼠48只,随机取8只作为正常对照组,其余40只造模。之后以香菇多糖和丽珠肠乐灌胃,14 d后处死。取肠内容物、血液,分别进行细菌培养、检测挥发性脂肪酸、内毒素。结果经过香菇多糖和丽珠肠乐治疗后,大鼠肠道双歧杆菌、乳酸杆菌的数量明显上升,大肠埃希菌、肠球菌的数量明显下降;肠内容物挥发性脂肪酸含量显著上升;血中内毒素含量显著下降。结论香菇多糖和丽珠肠乐均具有扶植正常菌群生长,调整菌群失调,提高机体免疫力,防治溃疡性结肠炎的作用;香菇多糖和丽珠肠乐联合应用效果更佳。     

中药"神曲"对脾虚小鼠肠道菌群的调整及肠保护作用研究

目的研究中药"神曲"对脾虚小鼠肠道菌群的调整及肠保护作用.方法1.昆明小白鼠,分成4组:A组(正常对照组),B组(脾虚自然恢复组),C组(神曲治疗组),D组(丽珠肠乐治疗组).2.检测结肠内容物和粪便标本的肠杆菌、肠球菌、双歧杆菌、类杆菌和乳酸杆菌数量.3.结肠组织光镜和电镜观察.结果脾虚小鼠给予神曲水煎剂治疗后,肠杆菌、肠球菌、双歧杆菌、类杆菌和乳酸杆菌数量逐渐恢复正常,肠壁肌层厚度增加,杯状细胞数量增多,肠黏膜微绒毛排列紊乱、线粒体肿胀显著改善,明显好于自然恢复组,与丽珠肠乐治疗组相比差异无显著性.结论中药神曲对脾虚小鼠具有肠道菌群调整及促进损伤肠组织恢复的作用.     

200株肠球菌系统鉴定及药敏试验的研究

本文报告200株肠球菌系统生理生化、血清学及药敏试验研究。其结果为:粪肠球菌165株,屎肠球菌21株,鸟肠球菌和孤立肠球菌各3株,希拉肠球菌2株,假鸟肠球菌、鸡肠球菌、芒地肠球菌、坚韧肠球菌各1株,2株未定种。148株含D抗原,占74%。对其进行青霉素、氨苄青霉素、氟哌酸和呋喃妥因药敏试验,敏感率较高,并发现屎肠球菌比粪肠球菌更耐药。对严重的肠球菌感染,在测定肠球菌高浓度(≥2g/L)氨基糖昔类耐药性指导下,以联合用药为佳。     

肠球菌耐万古霉素机制研究进展

肠球菌为革兰阳性（G＋）球菌,广泛分布于自然环境及人和动物消化道内,既往认为肠球菌是对人类无害的共栖菌。自20世纪80年代以来,肠球菌严重感染的发生率和病死率明显升高,肠球菌成为了院内感染的重要病原菌,不仅可引起尿路感染,皮肤软组织感染,甚至危及生命的腹腔感染、败血症、心内膜炎、脑膜炎等,在败血症中肠球菌为第三位的病原菌,仅次于凝固酶阴性葡萄球菌和金黄色葡萄球菌。由于肠球菌对多种抗菌药物具有天然耐药（固有耐药）和获得性耐药的特性,许多常用抗菌药物活性降低,往往造成临床治疗失败。为此,相研究对有关肠球菌的耐药机制的相关文献进行综述,以利于同道们进一步研究。     

肠球菌血流感染研究进展

摘要：近年来,随着肠球菌感染发生率的增加,有关肠球菌血流感染、尿路感染和腹腔感染的研究也逐渐增多,其中肠球菌血流感染病死率显著增加,预后不佳。临床上肠球菌感染以屎肠球菌和粪肠球菌为主。年龄、性别、致病菌种类及耐药情况、治疗方案的选择等均与肠球菌血流感染的发生和预后密切相关。此外,耐万古霉素肠球菌血流感染的治疗用药——达托霉素和利奈唑胺血药浓度及剂量的选择也被广泛关注。遵守临床操作规程,合理选择抗生素的种类及剂量浓度,严格监测药物使用情况,可减少血流感染的发生率,改善预后。现对肠球菌血流感染的发生及预后危险因素、治疗药物的选择进行综述,以期为肠球菌血流感染患者的临床治疗提供指导。     

血流感染粪肠球菌和屎肠球菌的临床分布及耐药研究

回顾性分析上海市某三甲医院血培养阳性标本中粪肠球菌和屎肠球菌的临床分布及对抗菌药物的耐药特征,为临床治疗其所致感染奠定基础。收集上海市某三甲医院2012年2月—2016年9月血流感染患者血液标本中的粪肠球菌和屎肠球菌,采用法国生物梅里埃公司的VITEK 2Compact全自动细菌鉴定和药敏分析系统进行细菌鉴定及药敏测定,研究细菌临床分布特点及对常用抗菌药物的耐药特征。共分离获得30株粪肠球菌和17株屎肠球菌。粪肠球菌样本主要来自泌尿科、消化科和血液科,所占比例分别为13.33%、16.67%和10.00%。粪肠球菌对青霉素、氨苄西林、环丙沙星、左氧氟沙星、四环素和红霉素的耐药率分别为13.33%、10.00%、36.67%、33.33%、66.67%和60.00%。屎肠球菌样本主要来自消化科(29.41%),其对以上抗菌药物的耐药率分别为88.24%、82.35%、88.24%、76.47%、23.53%和70.59%。屎肠球菌对青霉素、氨苄西林、环丙沙星和左氧氟沙星的耐药率显著高于粪肠球菌,而对四环素的耐药率显著低于粪肠球菌。两者均对替加环素、利奈唑胺和万古霉素敏感,但万古霉素对屎肠球菌的最低抑菌浓度显著低于粪肠球菌。结果提示,屎肠球菌对青霉素、氨苄西林、环丙沙星、左氧氟沙星的耐药率高于屎肠球菌,对万古霉素敏感,且其万古霉素最低抑菌浓度低于粪肠球菌。本研究为治疗这两种细菌所致感染的经验性用药提供了数据支持。     

两种肠球菌致重症患者尿路感染的耐药性比较

目的研究粪肠球菌和屎肠球菌致重症患者尿路感染现状并对其耐药特征进行比较分析,为临床合理选用抗菌药物,有效预防和控制感染提供依据。方法对2011年1月至2014年12月福建医科大学附属第二医院重症监护室尿路感染患者分离的172株肠球菌进行分析,用法国生物梅里埃Vitek2-Compact微生物鉴定仪鉴定肠球菌,K-B纸片扩散法进行药敏试验,利用WHONET 5.6软件分析处理试验数据。结果 172株肠球菌中,粪肠球菌和屎肠球菌分别占68.0%和32.0%;药敏试验表明两种肠球菌对利奈唑胺、万古霉素、替考拉宁都较敏感(耐药率5.0%),未检出对替加环素耐药的菌株,除这4种药物外,对其余12种抗菌药物差异存在统计学意义(χ2=36.15,P0.05)。4年间粪肠球菌除对四环素、替加环素外,屎肠球菌除对四环素、庆大霉素(高浓度)、替加环素外,对其余抗菌药物的耐药率的变化均呈显著升高的趋势(χ2=16.71,P0.05)。结论从该院重症患者尿液标本中分离出的肠球菌多重耐药严重,对大多数抗菌药物的耐药率呈逐年升高的趋势,两种肠球菌的耐药性存在菌种差异,临床应加强细菌监测,治疗肠球菌感染时首选利奈唑胺、万古霉素、替考拉宁、替加环素。     

引起院内感染的肠球菌和肠道中的肠球菌耐药性差异的研究

目的　研究临床分离的院内感染的肠球菌对常用抗生素的耐药性及与健康人肠道中的肠球菌的耐药性比较。方法　应用琼脂稀释法检测从临床分离的５２ 株肠球菌和健康人肠道中分离的肠球菌的最低抑菌浓度（ＭＩＣ） 。结果　肠球菌对临床常用的１１ 种抗生素的耐药性以万古霉素最低,ＭＩＣ５０ 为２ ,ＭＩＣ９０ 为４ 。屎肠球菌和粪肠球菌的耐药性对万古霉素有明显差异。院内感染分离的肠球菌和健康人肠道中的肠球菌的耐药性亦有显著的差异。结论　肠球菌对抗生素的敏感性以万古霉素最敏感,肠球菌应鉴定到种的水平以便更好地监控抗生素的耐药性。     

医院内感染的肠球菌和肠道中的肠球菌耐药性差异的研究

目的 研究临床分离的院内感染的肠球菌对常用抗生系的耐药性及与健康人肠道中的肠球菌的耐药性比较。方法 应用琼脂稀释法检测从临床分离的５２株肠球菌和健康人肠道中分离的肠球菌的最低抑菌浓度（ＭＩＣ）。结果 肠球菌对临床常用的１１种抗生素的耐药性以万古霉素最低,ＭＩＣ５０为２,ＭＩＣ９０为４。屎肠球菌和粪肠球菌的耐药性对万古霉素有明显差异。院内感染分离的肠球菌和健康人肠道中的肠球菌的耐药性亦有显著的差异。     

临床分离肠球菌的耐药性研究

目的了解近3年来粤东地区临床分离的肠球菌的耐药特征,为预防耐万古霉素肠球菌（VRE）的产生和控制VRE播散提供理论依据和实验基础。方法收集临床分离的215株肠球菌,细菌鉴定及药敏试验采用VITEK-60全自动细菌鉴定仪。结果215株肠球菌中,尿标本中分离肠球菌75株（35％）;痰液中分离出34株（16％）。粪肠球菌141株（65．5％）,屎肠球菌74株（34．5％）。粪肠球菌对万古霉素、呋喃妥因、青霉素G和莫西沙星的敏感率较高,70％～100％;对红霉素和四环素的敏感性较差,11％～33％。屎肠球菌对万古霉素敏感性较好为100％,四环素为62％;而对呋喃妥因、高链霉素、青霉素和左氧氟沙星等敏感性较差（5％～47％）。未检出耐万古霉素肠球菌。结论粤东地区近3年来未发现耐万古霉素肠球菌。肠球菌对各种常见抗生素敏感程度呈下降趋势。屎肠球菌较粪肠球菌耐药性更高。应根据细菌学培养结果合理用药,减少耐药菌株的发生率。     

临床分离肠球菌的分布特征及耐药性分析

目的:了解我院临床分离肠球菌的分布特征及耐药现状,为临床合理用药提供依据。方法:对我院2010年1月至2012年12月期间所有临床分离的肠球菌分布情况及药敏结果进行回顾性分析。结果:临床共分离肠球菌242株,粪肠球菌分离率(55.0%)高于屎肠球菌(40.9%),屎肠球菌分离率有增高的趋势。标本来源以尿液(62.9%)、分泌物(10.3%)、血液(6.9%)为主。肠球菌对万古霉素、替考拉宁的敏感性最高,均高于90%。发现耐万古霉素的肠球菌(VRE)7株,其中5株同时耐高浓度的氨基糖苷类抗生素(HLAR);对克林霉素、复方磺胺、阿米卡星、庆大霉素、妥布霉素、苯唑西林耐、头孢西丁耐药率最高,均高于95%。屎肠球菌对青霉素类、氨苄西林、红霉素、呋喃妥因、环丙沙星耐药率均高于粪肠球菌;对四环素、奎努普丁/达福普汀耐药率低于粪肠球菌。结论:肠球菌是临床感染重要病原菌,且具有多重耐药性,屎肠球菌和粪肠球菌耐药水平差异较大,临床应根据药敏结果合理选择抗菌药物。     

肝硬化患者肠球菌感染及体外药敏监测

目的研究肝硬化患者肠球菌感染的现状及药敏特点,以加强对肝硬化肠球菌感染的认识,指导用药。方法留取标本进行细菌培养、鉴定及药敏试验。结果所有纳入研究范围的肝硬化患者共检出肠球菌112株,其中粪肠球菌89株,占79.5%,比例最高,屎肠球菌占14.3%,居第2位。腹水中检出肠球菌64株,占57.1%,其次为痰和尿液,分别为38.1%和14.4%。肠球菌对红霉素、奈替米星的耐药率超过80%,对青霉素G、氨苄西林、呋喃妥因的敏感率超过70%,对左氧氟沙星的敏感率为58.9%,对头孢唑啉、头孢派酮的敏感率分别只有25.0%和33.0%,检出高耐氨基糖苷类肠球菌(HLAR)58株,占51.8%,未检出耐万古霉素和替考拉宁肠球菌,但检出万古霉素中介肠球菌4株,占3.6%。结论肠球菌是肝硬化患者医院感染的重要致病菌,尤以粪肠球菌和屎肠球菌为主,屎肠球菌的耐药率高于粪肠球菌,万古霉素和替考拉宁是治疗肠球菌感染的首选药物。     

肠球菌的临床感染与耐药性分析

目的了解温州医学院附属第一医院临床分离主要肠球菌的分布及其对常用抗菌药物的耐药现状,以指导临床合理用药。方法对2008年至2011年临床分离的635株粪肠球菌和屎肠球菌的标本来源和药敏结果进行回顾性分析。结果各种临床标本中两种肠球菌的分布比例存在差异,总体以尿液标本所占比例最多,且屎肠球菌的总体分离率高于粪肠球菌。粪肠球菌对利奈唑胺、氨苄西林、万古霉素、呋喃妥因和替考拉宁的耐药率都在5．0％以下,对莫西沙星和青霉素G的耐药率也仅为7．0％和6．7％;屎肠球菌对莫西沙星、左旋氧氟沙星、环丙沙星、氨苄西林、青霉素G和红霉素的耐药率都在90．0％以上,对利奈唑胺、万古霉素、替考拉宁和奎奴敏感。粪肠球菌的多重耐药株占总数的26．4％,屎肠球菌的多重耐药株占总数的78．2％。结论粪肠球菌和屎肠球菌对15种抗菌药物的耐药情况不同,屎肠球菌具有更高的耐药率和更广的耐药谱。临床应根据药敏试验的结果合理选择抗菌药物,以防止耐药菌株的产生和播散。     

Identification and tracing of Enterococcus spp. by RAPD-PCR in traditional fermented sausages and meat environment

Aims:  Four local small-scale factories were studied to determine the sources of enterococci in traditional fermented sausages.
Methods and Results:  Different points during the production of a traditional fermented sausage type ( fuet ) were evaluated. Randomly amplified polymorphic DNA (RAPD)-PCR was used to type 596 Enterococcus isolates from the final products, the initial meat batter, the casing, the workers' hands and the equipment. Species-specific PCR-multiplex and the partial sequencing of atpA gene and 16S rRNA gene sequencing allowed the identification of the isolates: Enterococcus faecalis (31·4%), Enterococcus faecium (30·7%), Enterococcus sanguinicola (14·9%), Enterococcus devriesei (9·7%), Enterococcus malodoratus (7·2%), Enterococcus gilvus (1·0%), Enterococcus gallinarum (1·3%), Enterococcus casseliflavus (3·4%), Enterococcus hermanniensis (0·2%), and Enterococcus durans (0·2%) . A total of 92 different RAPD-PCR profiles were distributed among the different factories and samples evaluated. Most of the genotypes found in fuet samples were traced back to their source.
Conclusions:  The major sources of enterococci in the traditional fermented sausages studied were mainly the equipment followed by the raw ingredients, although a low proportion was traced back to human origin.
Significance and Impact of the Study:  This work contributes to determine the source of enterococcal contamination in fermented sausages and also to the knowledge of the meat environment.     

190株肠球菌的鉴定及药敏分析

目的了解黑龙江省医院肠球菌的菌种分布及对常用抗生素耐药性的现状。方法对2004年8月至2006年6月检出的190株肠球菌的菌种鉴定及药敏结果进行回顾性分析。结果粪肠球菌(46.3%)分离率下降;屎肠球菌(33.2%)、鹑鸡肠球菌(13.7%)分离率增加。耐药株检出率屎肠球菌为85.1%,粪肠球菌为75.0%,鹑鸡肠球菌为70.2%。青霉素和呋喃妥因对粪肠球菌引起的感染有一定的疗效,万古霉素,替考拉宁是治疗肠球菌引起感染的最佳选择。结论肠球菌已成为引起临床感染的重要致病菌,它的天然耐药和多重耐药的特性使得临床可选治疗药物范围狭窄。应防止耐万古霉素肠球菌株的产生。     

Antimicrobial resistance of Enterococcus species isolated from produce

The purpose of this study was to characterize the antibiotic resistance profiles of Enterococcus species isolated from fresh produce harvested in the southwestern United States. Among the 185 Enterococcus isolates obtained, 97 (52%) were Enterococcus faecium, 38 (21%) were Enterococcus faecalis, and 50 (27%) were other Enterococcus species. Of human clinical importance, E. faecium strains had a much higher prevalence of resistance to ciprofloxacin, tetracycline, and nitrofurantoin than E. faecalis. E. faecalis strains had a low prevalence of resistance to antibiotics used to treat E. faecalis infections of both clinical and of agricultural relevance, excluding its intrinsic resistance patterns. Thirty-four percent of the isolates had multiple-drug-resistance patterns, excluding intrinsic resistance. Data on the prevalence and types of antibiotic resistance in Enterococcus species isolated from fresh produce may be used to describe baseline antibiotic susceptibility profiles associated with Enterococcus spp. isolated from the environment. The data collected may also help elucidate the role of foods in the transmission of antibiotic-resistant strains to human populations.     

耐甲氧西林葡萄球菌和肠球菌blaTEM及tetM基因检测

目的了解临床分离的耐甲氧西林葡萄球菌(MRS)和肠球菌中blaTEM及tetM基因存在状况。方法分离50株耐甲氧西林金黄色葡萄球菌(MRSA),7株耐甲氧西林表皮葡萄球菌(MRSE)、5株耐甲氧西林溶血葡萄球菌(MRSH)、15株粪肠球菌和9株屎肠球菌,采用PCR技术检测耐药基因。结果MRSA、MRSE、MRSH、粪肠球菌和屎肠球菌中blaTEM基因阳性率分别为40.0%、57.1%、60.0%、6.7%和88.9%,tetM基因阳性率分别为100%、0%、0%、66.7%、0%。结论blaTEM基因阳性率在MRS中较高,在屎肠球菌中则很高;携带tetM基因是MRSA和粪肠球菌对四环素耐药的主要原因。     

Population structure and safety aspects of Enterococcus strains isolated from artisanal dry fermented sausages produced in Argentina

Enterococci population from Argentinean artisanal dry fermented sausage was identified and their safety aspects were evaluated. Species-specific PCR was used to distinguish between Enterococcus faecium (56%) and Enterococcus faecalis (17%). Other isolates (27%) were identified as Enterococcus durans , Enterococcus casseliflavus and Enterococcus mundtii by using 16S RNA gene sequence. RAPD analyses showed different biotypes for Ent. faecium and Ent. faecalis species. Low incidence of antibiotic resistance and high virulence traits in Ent. casseliflavus and Ent. faecalis were found; the majority of the Ent. faecium strains were shown to be free of virulence factors. The absence of virulence/resistance traits and the anti-Listeria activity of Ent. faecium isolates may be exploited to enhance natural preservation thereby guaranteeing organoleptic/safety characteristics of artisanal fermented sausages.     

Comparison of 16S rRNA sequencing with conventional and commercial phenotypic techniques for identification of enterococci from the marine environment

AIMS: To compare accuracy of genus and species level identification of presumptive enterococci isolates from the marine environment using conventional biochemical testing, four commercial identification systems and 16S rRNA sequence analysis. METHODS AND RESULTS: Ninety-seven environmental bacterial isolates identified as presumptive enterococci on mEI media were tested using conventional and Enterococcus genus screen biochemical tests, four commercial testing systems and 16S rRNA sequencing. Conventional and Enterococcus genus screen biochemical testing, 16S rRNA sequencing and two commercial test systems achieved an accuracy of > or = 94% for Enterococcus genus confirmation. Conventional biochemical testing and 16S rRNA sequencing achieved an accuracy of > or = 90% for species level identification. CONCLUSIONS: For confirmation of Enterococcus genus from mEI media, conventional or genus screen biochemical testing, 16S rRNA sequencing and the four commercial systems were correct 79-100% of the time. For speciation to an accuracy of 90% or better, either conventional biochemical testing or 16S rRNA sequencing is required. SIGNIFICANCE AND IMPACT OF THE STUDY: Accurate identification of presumptive environmental Enterococcus isolates to genus and species level is an integral part of laboratory quality assurance and further characterization of Enterococcus species from pollution incidents. This investigation determines the ability of six different methods to correctly identify environmental isolates.