2004—2014年尿标本分离粪肠球菌和屎肠球菌药物敏感性变迁

发布时间：2018-06-07 06:13

本文选题：尿标本 + 粪肠球菌　；参考：《中国感染控制杂志》2017年04期

【摘要】：目的了解临床尿标本分离粪肠球菌和屎肠球菌药物敏感性状况及变迁,为临床抗感染治疗提供实验室依据。方法分析2004—2014年全国20所三级医院患者尿标本分离的粪肠球菌和屎肠球菌的药物敏感性,采用聚合酶链反应(PCR)检测万古霉素耐药肠球菌(VRE)的耐药基因。结果 2004—2014年共分离菌株788株,其中粪肠球菌371株,屎肠球菌417株。粪肠球菌对氨苄西林、呋喃妥因、磷霉素、万古霉素和替考拉宁的敏感率均90%,对利福平、米诺环素和红霉素的敏感率均20%,2011年7月—2012年6月与2009年7月—2010年6月粪肠球菌对磷霉素敏感率比较,差异有统计学意义(P0.0167)。屎肠球菌对万古霉素和替考拉宁的敏感率分别为96.9%和97.4%,对呋喃妥因、米诺环素和磷霉素的敏感率分别为41.7%、51.8%和78.2%,对氨苄西林、左氧氟沙星、利福平和红霉素的敏感率均10%;屎肠球菌对呋喃妥因敏感率不同年份有降低趋势(任两组比较均P0.0167),2011年7月—2012年6月、2013年7月—2014年6月磷霉素敏感率较2009年7月—2010年6月有所降低(均P0.0167),其他药物不同年份药敏情况无显著变化。14株VRE均携带vanA耐药基因。结论尿标本分离的粪肠球菌对氨苄西林、呋喃妥因和磷霉素均较敏感,屎肠球菌对大部分抗菌药物敏感性相对较差;粪肠球菌和屎肠球菌对万古霉素和替考拉宁相对敏感,仅少数菌株耐药。
[Abstract]:Objective to investigate the drug sensitivity of Enterococcus faecalis and Enterococcus faecium in clinical urine and to provide laboratory evidence for clinical anti-infective therapy. Methods the drug sensitivity of Enterococcus faecalis and Enterococcus faecium isolated from urine samples of 20 tertiary hospitals in China from 2004 to 2014 were analyzed. The resistant genes of vancomycin resistant Enterococcus faecium were detected by polymerase chain reaction (PCR). Results A total of 788 strains were isolated from 2004 to 2014, among them 371 strains of Enterococcus faecalis and 417 strains of Enterococcus faecium. The sensitivity of Enterococcus faecalis to ampicillin, furantoin, fosfomycin, vancomycin and teicoplanin were 90%, respectively. The sensitivity rates of minocycline and erythromycin were both 20. The sensitivity of Enterococcus faecalis to fosfomycin from July 2011 to June 2012 was significantly higher than that from July 2009 to June 2010 (P 0.0167). The sensitivities of Enterococcus faecium to vancomycin and teicoplanin were 96.9% and 97.4% respectively, and to furantoin, minocycline and fosfomycin were 41.7% and 78.2%, respectively, to ampicillin and levofloxacin. The susceptibility of Enterococcus faecium to furantoin decreased in different years (both P 0.0167, July 2011 to June 2012, July 2013 to June 2014, compared with July 2009). -decreased in June 2010 (all P0.0167, no significant change in drug sensitivity in different years of other drugs. All 14 strains of VRE were carrying vanA resistance genes. Conclusion Enterococcus faecalis isolated from urine specimen is sensitive to ampicillin, furantoin and fosfomycin, and Enterococcus faecium is relatively sensitive to most antibiotics, and Enterococcus faecalis and Enterococcus faecium are relatively sensitive to vancomycin and teicoplanin. Only a few strains were resistant to drugs.
【作者单位】：北京大学第一医院;
【基金】：国家自然科学基金(81171612) 首都临床特色应用研究与推广项目(Z161100000516040)
【分类号】：R446.5

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