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目的了解肠球菌所致临床感染分布及其对12种抗生素的耐药情况。方法临床分离标本用常规方法或Vitek系统鉴定,采用琼脂扩散法(k-b法)进行药敏试验。结果2008年1月至2009年1月期间临床分检出176株肠球菌:前四位送检标本种类依次为:尿液(48例)、血液(33例)、创面及伤口分泌物(29例)、痰液(27例)。176株肠球菌中,粪肠球菌108株(占61.4%),屎肠球菌66株(占37.5%),母鸡肠球菌与铅黄肠球菌各1株(占1.1%),万古霉素中介肠球菌7株,占肠球菌分离总数的4.0%,未发现耐万古霉素肠球菌(VRE),庆大霉素高水平耐药(HLGR)肠球菌65株,占肠球菌分离总数的36.9%。结论肠球菌在血液、创面及伤口分泌物和痰液中分离率增高,可能与近些年侵入性治疗手段和机会增多,免疫抑制剂应用增多及重症患者自身免疫力降低有关;肠球菌对临床常用12种抗生素以万古霉素、替考拉宁、呋喃妥因最敏感,对其他抗生素均有不同程度耐药。临床应注意结合体外药敏试验结果合理用药。
Objective To understand the distribution of clinical infection caused by enterococci and their resistance to 12 antibiotics. Methods The clinical isolates were identified by the conventional method or the Vitek system. The agar diffusion method (k-b method) was used to conduct drug susceptibility tests. Results A total of 176 strains of enterococci were detected clinically in the period from January 2008 to January 2009. The first four specimens were urine (48 cases), blood (33 cases), wounds and wound secretions Cases), sputum (27 cases). Of the 176 enterococci, 108 Enterococcus faecalis (61.4%), Enterococcus faecium 66 (37.5%), Enterococcus faecalis and Leuconostoc enterica 1 (1.1%), Vancomycin intermediates Enterococcus faecalis 7, accounting for 4.0% of the total number of enterococci isolated, did not find vancomycin-resistant enterococci (VRE), gentamicin high level drug resistance (HLGR) enterococci 65, accounting for 36.9% . Conclusion Enterococci in the blood, wounds and wound secretions and sputum increased the rate of separation may be related to invasive treatment methods and opportunities in recent years, increased use of immunosuppressive agents and decreased autoimmune severe patients; enterococci clinical Commonly used 12 kinds of antibiotics to vancomycin, teicoplanin, nitrofurantoin most sensitive to other antibiotics have varying degrees of resistance. Clinical should pay attention to the combination of drug susceptibility test results in vitro rational use of drugs.