郭远瑜, 沈丽芳, 赵成国, 毛剑锋, 沈利蒙, 董华丽. 2007-2012年浙江萧山医院尿路感染患者的肠球菌分布及耐药性分析[J]. 疾病监测, 2013, 28(11): 947-951. DOI: 10.3784/j.issn.1003-9961.2013.11.022
引用本文: 郭远瑜, 沈丽芳, 赵成国, 毛剑锋, 沈利蒙, 董华丽. 2007-2012年浙江萧山医院尿路感染患者的肠球菌分布及耐药性分析[J]. 疾病监测, 2013, 28(11): 947-951. DOI: 10.3784/j.issn.1003-9961.2013.11.022
GUO Yuan-yu, SHEN Li-fang, ZHAO Cheng-guo, MAO Jian-feng, SHEN Li-meng, DONG Hua-li. Distribution and drug resistance of Enterococci in patients with urinary tract infection in Xiaoshan Hospital, Zhejiang, 2007-2012[J]. Disease Surveillance, 2013, 28(11): 947-951. DOI: 10.3784/j.issn.1003-9961.2013.11.022
Citation: GUO Yuan-yu, SHEN Li-fang, ZHAO Cheng-guo, MAO Jian-feng, SHEN Li-meng, DONG Hua-li. Distribution and drug resistance of Enterococci in patients with urinary tract infection in Xiaoshan Hospital, Zhejiang, 2007-2012[J]. Disease Surveillance, 2013, 28(11): 947-951. DOI: 10.3784/j.issn.1003-9961.2013.11.022

2007-2012年浙江萧山医院尿路感染患者的肠球菌分布及耐药性分析

Distribution and drug resistance of Enterococci in patients with urinary tract infection in Xiaoshan Hospital, Zhejiang, 2007-2012

  • 摘要: 目的 调查从尿路感染患者分离的肠球菌的菌种、临床分布及耐药性,为临床合理选用抗生素提供依据。方法 尿培养采用经典型浸片Uricult,ATB-Expression细菌分析系统进行鉴定和药敏试验;所有资料采用Whonet 5.6软件进行回顾性分析。结果 分离肠球菌238株,主要为粪肠球菌122株(51.3%)和屎肠球菌95株(39.9%);菌株主要来源列前2位的是内科(38.2%)和泌尿外科(21.0%);耐药率较高的是红霉素(86.5%)、利福平(75.7%)和四环素(66.4%);较低的是呋喃妥因(19.7%)、万古霉素(9.6%)和利奈唑胺(0.0%);粪肠球菌对利福平、红霉素、奎奴普丁/达福普汀和四环素的耐药率较高,均76.5%,万古霉素耐药率0.9%;屎肠球菌对氨苄西林等8种药物耐药率75.8%,万古霉素耐药率4.3%。粪肠球菌对所测试抗生素耐药率仅有四环素、奎奴普丁/达福普汀高于屎肠球菌,其余低于屎肠球菌;利福平、万古霉素和利奈唑胺耐药率在二者间差异无统计学意义。2007年与2012年相比,青霉素、氨苄西林等药物耐药率上升,而环丙沙星、四环素等下降。结论 肠球菌是引起尿路感染的重要病原菌,以粪肠球菌和屎肠球菌为主,不同种类肠球菌耐药率差别较大,加强细菌培养和定期分析其耐药性,有助于提高临床治愈率及合理用药水平。

     

    Abstract: Objective To investigate the distribution and drug resistance of Enterococci in patients with urinary tract infection and provide evidence for the rational use of antibiotics. Methods The urine specimen was cultured in Uricult. The identification of clinical isolates of Enterococci and their drug susceptibility test were conducted with ATB-Expression system, and the data were analyzed with Whonet 5.6 software. Results A total of 238 Enterococcus strains were detected, including 122 strains of E. faecalis (51.3%) and 95 strains of E. faecium (39.9%). The strains were mainly detected in department of internal medicine (38.2%) and department of urology (21.0%). The resistance rate of the Enterococcus strains was 86.5% to erythromycin, 75.7% to rifampin, 66.4% to tetracycline, 19.7% to nitrofurantoin, 9.6% to vancomycin and 0.0% to linezolid. The resistant rates of E. faecalis strains were 76.5% to rifampicin, erythromycin, quinupristin/dalfopristin and tetracycline, 0.9% to vancomycin. The resistant rates of E. faecium strains were 75.8% to ampicillin and other antibiotics and 4.3% to vancomycin. The resistant rates of E. faecalis strains to most antibiotics were lower than E. faecium strains, except tetracycline, quinupristin/dalfopristin. The differences in resistant rates to rifampicin, vancomycin and linezolid between E. faecium and E. faecalis had no statistical significance; Compared with 2007, the resistant rates of Enterococci to penicillin, ampicillin and other antibiotics increased in 2012, but the resistant rates to ciprofloxacin and tetracycline declined. Conclusion Enterococci are the major pathogens causing urinary tract infection, mainly including E. faecalis and E. faecium. The resistant rates vary greatly with different Enterococci. It is important to enhance bacterial culture and regular analysis of drug resistance to improve clinical cure rate and rational use of antibiotics.

     

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