泌尿系统分离肠球菌耐药性分析

目的了解该院患者泌尿系统分离的肠球菌耐药现状,为临床合理用药提供依据。方法对该院2011年1月至2012年12月期间所有泌尿系统分离的肠球菌药敏结果进行回顾性分析。结果泌尿系统共分离肠球菌109株,屎肠球菌分离率（53.2%）,略高于粪肠球菌（44.0%）。肠球菌对万古霉素、替考拉宁的敏感性最高,均高于90%。发现耐万古霉素的屎肠球菌（VRE）4株,其中3株同时耐高浓度的氨基糖苷类抗菌药物（HLAR）;对红霉素、克林霉素、复方磺胺、阿米卡星、庆大霉素、妥布霉素、苯唑西林、头孢西丁耐药率最高,均高于90%。屎肠球菌对青霉素类、氨苄西林、呋喃妥因、环丙沙星耐药率均高于粪肠球菌;对四环素、奎努普丁/达福普汀耐药率低于粪肠球菌。结论肠球菌是引起泌尿系统感染的重要病原菌之一,且呈多重耐药性,屎肠球菌和粪肠球菌耐药水平差异较大,临床应根据不同种类的肠球菌及药敏结果合理选择抗菌药物。

Resistance analysis of Enterococcusisolated from urinary system

Objective Understanding of Enterococcus resistant status of our hospital patients with urinary system,and provide the basis for the clinical use of drugs.Methods All susceptibility results of Enterococcus isolated from urinary system in our hospital during January 2011to December 2012was analyzed retrospectively.Results 109Enterococcus were isolated from the urinary system,Enterococcus faecium isolation rate（53.2%）was slightly higher than Enterococcus faecalis（44.0%）,sensitivity to Vancomycin,Teicoplanin were highest,higher than 90%.Found resistant to Vancomycin Enterococcus faecium（VRE）four strains,three of them at the same time resistant to high concentrations of Aminoglycoside antibiotics（HLAR）;Erythromycin,Clindamycin,Sulfamethoxazole,Amikacin,Gentamicin,Tobramycin,Oxacillin,Cefoxitin resistance was the highest,resistance rates were higher than 90%.Enterococcus faecium to penicillin,Ampicillin,Nitrofurantoin,Ciprofloxacin resistance rates were higher than Enterococcus faecalis;Tetracyclin,Quinuperistin/Dalfopritin resistance rates were lower than Enterococcus faecalis.Conclusion Enterococcus is one of the important pathogen causing urinary tract infections,and showed multiple drug resistance,Enterococcus faecium and Enterococcus faecalis resistance level is quite different,Clinical rational selection of antibiotics should be based on different types of Enterococcus and susceptibility results.