摘要
目的比较分析粪肠球菌和屎肠球菌致重症监护室(ICU)和非ICU患者医院感染的耐药特征,为临床合理选用抗菌药物提供依据。方法对2017年1月-2018年11月金华市中心医院ICU与非ICU分离出肠球菌的标本来源和药敏试验结果进行比较分析。结果376株粪肠球菌和屎肠球菌主要来源于中段尿(64.0%),其次是胆汁和血液,分别占11.9%和5.9%。除四环素和利奈唑胺,粪肠球菌对常用抗菌药物的耐药率普遍低于尿肠球菌,2种肠球菌对红霉素的耐药率均较高。粪肠球菌从ICU分离株对临床常用抗菌药物的耐药率普遍高于非ICU分离株(P<0.05)。屎肠球菌天然高度耐药,ICU与非ICU分离株对14种常用抗菌药物的耐药率差异均无统计学意义(P>0.05)。结论粪肠球菌和屎肠球菌以泌尿系统感染为主,耐药情况严重,治疗肠球菌感染应根据菌种差异、标本来源ICU与非ICU、药敏试验结果选用抗菌药物。
Objective To comparatively analyze the drug resistance characteristics of nosocomial infections in intensive care unit ( ICU) and non-ICU patients with Enterococcus faecalis and Enterococcus faecium, so as to provide basis for the clinical use of antibacterial drugs. Methods The source and drug sensitivity test results of Enterococcus faecalis and Enterococcus faecium isolated from ICU and non-ICU in Jinhua Central Hospital from January 2017 to November 2018 were compared and analyzed. Results 376 strains of Enterococcus faecalis and Enterococcus faecium were mainly derived from middle-stage urine (64. 0%), followed by bile and blood, accounting for 11. 9% and 5. 9%. In addition to tetracycline and linezolid, the resist-ance rate of Enterococcus faecalis to commonly used antibiotics was generally lower than that of Enterococcus faecium, both of the enterococei had high resistance to erythromycin. The esistance rate of Enterococcus faecalis from ICU isolates to clinically used antibiotics was generally higher than that of non-ICU isolates (P<0. 05). Enterococcus faecium was highly resistant to natural disease, and the difference in resistance rates between 14 ICU and non-ICU isolates was not statistically significant ( P > 0.05). Conclusion The urinary system infection is mainly ceaused by Enterococcus faecalis and Enterococcus faecium. The drug resistance is serious. The treatment of Enterococcus infection should be based on the strain, the source of the specimen ( ICU and non-ICU),and the drug sensitivity test results.
作者
余安乐
方寅飞
YU An-le;FANG Yin-fei(Clinical Laboratory, Lanxi Maternal and Child Health-care and Family Planning Service Center, Lanxi, Zhejiang 321100, China)
出处
《中国卫生检验杂志》
CAS
2019年第19期2335-2338,2350,共5页
Chinese Journal of Health Laboratory Technology
关键词
粪肠球菌
屎肠球菌
重症监护室
医院感染
耐药性
Enterococcus faecalis
Enterococcus faecium
Intensive care unit
Nosocomial infection
Drug resistance
