血流感染粪肠球菌和屎肠球菌的临床分布及耐药研究

发布时间：2018-06-07 16:48

本文选题：血流感染 + 粪肠球菌　；参考：《微生物与感染》2017年01期

【摘要】：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。
[Abstract]:The clinical distribution and antimicrobial resistance of Enterococcus faecalis and Enterococcus faecium in blood culture positive samples of a third Class A Hospital in Shanghai were analyzed retrospectively, which laid a foundation for clinical treatment of infection caused by Enterococcus faecalis. Enterococcus faecalis and Enterococcus faecium were collected from blood samples of patients with blood flow infection in a third Class A Hospital in Shanghai from February 2012 to September 2016. The bacterial identification and drug sensitivity analysis system (VITEK 2Compact) of French Bio-Meridier Company was used to study the clinical distribution of bacteria and their resistance to common antimicrobial agents. A total of 30 strains of Enterococcus faecalis and 17 strains of Enterococcus faecium were isolated. The samples of Enterococcus faecalis mainly come from urology, digestive department and hematology department. The proportion of Enterococcus faecalis is 13.33% and 10.00% respectively. The resistance rates of Enterococcus faecalis to penicillin, ampicillin, ciprofloxacin, levofloxacin, tetracycline and erythromycin were 13.3310.00 and 36.67%, respectively. The resistance rate of Enterococcus faecium to the above antimicrobial agents was 88.242.35 and 76.4723.53% and 70.5995% respectively. The resistance rate of Enterococcus faecium to penicillin, ampicillin, ciprofloxacin and levofloxacin was significantly higher than that of Enterococcus faecalis, but the resistance rate to tetracycline was significantly lower than that of Enterococcus faecalis. Both were sensitive to tegacycline, linazolamine and vancomycin, but the minimum inhibitory concentration of vancomycin against Enterococcus faecium was significantly lower than that of Enterococcus faecalis. The results suggested that Enterococcus faecium was more resistant to penicillin, ampicillin, ciprofloxacin and levofloxacin than Enterococcus faecium, and was sensitive to vancomycin, and its minimum inhibitory concentration of vancomycin was lower than that of Enterococcus faecalis. This study provides data support for empirical drug use in the treatment of these two bacterial infections.
【作者单位】：上海交通大学附属第一人民医院检验医学科;上海交通大学附属第一人民医院临床药学科;
【基金】：国家青年科学基金(31500154) 上海市科学技术委员会“扬帆计划”(15YF1409500) 上海市卫生和计划生育委员会科研课题(201440289) 上海市第一人民医院“优青前计划”(06N1503012)
【分类号】：R446.5

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