2007～2010年粪肠球菌、屎肠球菌耐药性变迁分析

摘要

To investigate the drug resistance transition of clinical isolates of Enterococcus faecalis (E. faecalis) and Enterococcus faecium (E.faecium) in Aerospace Center Hospital from 2007 to 2010. Methods 512 strains of E. faecalis and 797 strains of E. faecium, isolated from different specimens between Jan 2007 and May 2010, were identified by Vitek 2, and detected for their sensitivity to 14 kinds of antibiotics. Results The isolation rate of E. faecium increased significantly, while there was no signif icant variation of E. faecalis during the period. The drug resistance rate of E. faecalis to penicillin,ampicillin, nitrofurantoin,vancomycin and teicoplanin increased significantly. Increasing trends were also found in the drug resistance rate of E. faecium to nitrofurantoin, vancomycin, teicoplanin and quinupristin/dalfopristin, while the drug resistance rate to other antibiotics decreased, among which tetracycline decreased mostly. Conclusion The isolation and drug-resistance rate rate of E. faecalis and E. faecium both presented raising trends, with vancomycin-resistant strains increased mostly. Surveillance and control of drug-resistance of enterococcus should be strengthened to reduce the infection and spread of drug-resistance strains in hospital.%目的 调查2007～2010年间航天中心医院粪、屎肠球菌临床分离株的耐药变迁情况.方法 使用Vitek 2全自动细菌检测分析系统对2007年1月至2010年5月从各类临床标本中分离的512株粪肠球菌和797株屎肠球菌进行菌株鉴定,并测定其对14种抗菌剂的敏感性.结果 4年间粪肠球菌的检出率变化不显著,屎肠球菌则显著增高.粪肠球菌对青霉素、氨苄西林、呋喃妥因、万古霉素以及替考拉宁的耐药率变化均呈显著升高趋势.屎肠球菌对呋喃妥因、万古霉素、替考拉宁以及喹奴普汀/达福普汀的耐药率也呈上升趋势,而对其他抗菌剂的耐药率有不同程度的降低,其中以四环素下降最为明显.结论 粪、屎肠球菌的检出率和耐药率均呈上升趋势,尤其万古霉素耐药株明显增多,应加强对其耐药性监测和防控,减少耐药菌株在院内感染及传播.