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。

Study on the drug resistance of clinieally isolated Enterococcus

Objective To investigate the distribution and drug-resistant features of clinical specimens of Enterococcus faecalis and Enterococcus faecium in recent years. Methods Enterococcus from 2002 to 2007 were identified and their antimicrobial susceptibility tests were performed by AMS VITEK--60. Results 215 strains of Enterococcus were isolated,141 of which were Enterococcus faecalis and 74 were Enterococcus faecium; 35% of Enterococcus were isolated from urine sampies, 16% were isolated from sputum samples. Enterococcus faecalis had higher antimicrobial susceptibility rate to Vancomycin, Nitrofunantoin, Penicillin-G and Moxifloxacin （70% - 100% ） and lower antimicrobial susceptibility rate to Erythromycin and Tetracycline （11% -33% ）. Enterococcus faecium had higher antimicrobial susceptibility rate to Vancomycin （ 100% ） and Tetracycline （62%） and lower antinficrobial susceptibility rate to Nitrofunantoin, Streptomycin 2000, Penicillin-G and Levofloxacin （5% -47% ）. No Vancomycin-resistant Enterococcus were detected in the study. Conclusion The drug sensitiviy of Enterococcus to various common antibiotics had decreased in recent years. Enterococcus faecalis has a higher antimicrobial susceptibility rate than Enterococcus faecium. The clinical use of antibiotics must be based on the results of susceptibil.ty of pathogens to reduce the incidence of drug resistant strains.