2000年至2006年屎肠球菌的临床分离与耐药变迁

目的了解本地区屎肠球菌在临床的分离与耐药变迁情况,为临床抗感染的预防与治疗提供帮助。方法用WHONET 5软件统计分析我院2000年至2006年屎肠球菌临床分离株在各病区、样本中的分布与耐药性的变迁情况。结果分离率呈逐年上升趋势,从2000年的0.32%上升到2006年的0.81%;7年中以重症监护病区（ICU）分离菌株最高,占总分离菌株的68.9%,其次为肾内科病区占13.5%;在送检标本中以尿液标本分离菌株数最高,占总分离数的62.3%,其次为痰液（10.2%）。对11种抗生素的耐药性分析显示,屎肠球菌对青霉素G、氨苄西林、庆大霉素500、环丙沙星、左旋氧氟沙星呈较高的耐药率,而对四环素、呋喃妥因、链霉素2000相对较低;更值得我们注意的是对于万古霉素的耐药率呈逐年上升趋势,对于喹奴普汀/达福普汀、力奈唑烷这两类临床还未运用的抗生素已有一定的耐药率。结论屎肠球菌在临床的分离率在逐年增加,已成为医院内感染的主要病原菌之一,该菌呈多重耐药的特性,并呈不断增加趋势,临床抗感染治疗应以分离菌株的体外抗菌药物敏感性为依据。

Analysis of the isolation and variance of resistance to antibiotics of Enterococcus faecium from 2000 to 2006

Objective To review and analyze the isolation and resistance of Enterococcusfaecium in clinical specimens from 2000 to 2006 to show the tendency of that in our hospital, and to help carrying on the prevention and therapy of infection. Methods The date of isolation and resistance to 3 kinds of antibiotics of Enterococcusfaecium in the recent seven years were analyzed statistically with WHONET 5 softwere. Results The isolation rate of Enterococcus faecium was 0.32% in 2000,but 0.81% in 2006. In the recent seven years,there was a highest isolation rate （6g. 9% of all the strains） from the speciments of ICU ,the second was from the department of kidney with 13.5%. And the strain isolation rate from the urinary speciments was the highest（62.3% ） in all the speciments ,sputum was secondarily higher（ 10.2% ）. Enterococcus faecium showed high resistance rate （ more than 50.0% ） to those including Penicillin, Ampicillin,Gentamycin 500 mg/L, Ciprofloxacin, Levofoxacin. But for Tetracycline, Nitrofuration, Streptomycin 2000 mg/L had a certain activity. Worthy of what we notice was year by year to the Vancomycin to bear a medicine rate to present up-trend. The antibiotics hadn＇t made use of for the Quinupristin/Dalfopfisfin, Linezolid these two types of clinically had alreagy certainly had to bear a medicine rate. Conclusion Enterococcus faecium had become one of the predominant pathogen of nosoeominal infection. And the isolation rate as well as the resistance to most of the antibiotics had been increasing in clinical specimens. So the therapy of infection should be based on the antibiotics susceptibility test in vitro.