CAJ | 학술논문

目的：了解内蒙古鄂尔多斯市中心医院临床分离的肠球菌属细菌的分布情况及对各类抗菌药物的耐药性。方法使用 VITEK 2 compact全自动细菌检测分析系统对2010年1月至2013年6月从临床标本中分离的271株肠球菌属细菌进行菌种鉴定和药敏试验，并用 WHONET5．6软件对结果进行统计分析。结果271株肠球菌属细菌中，屎肠球菌137株（50．6％），粪肠球菌80株（29．5％），其他肠球菌54株（19．9％）。肠球菌属细菌主要分离自尿液69株（25．5％）、脓液40株（14．8％）、伤口等分泌物34株（12．5％）。粪肠球菌对万古霉素和利奈唑胺的耐药率分别为1．3％和1．5％；未检出呋喃妥因耐药株；对青霉素和氨苄西林的耐药率较低，分别为11．8％和2．6％；对高浓度庆大霉素和高浓度链霉素的耐药率分别为31．0％和22．9％。屎肠球菌的耐药率明显高于粪肠球菌，对万古霉素的耐药率为4．4％，未检出利奈唑胺耐药株，对呋喃妥因的耐药率为19．1％；对高浓度庆大霉素和高浓度链霉素的耐药率分别为44．8％和26．4％；但对四环素和奎奴普丁-达福普汀的耐药率低于粪肠球菌，分别为58．3％和0。结论屎肠球菌对抗菌药物的耐药率较粪肠球菌高；并已出现对万古霉素耐药株；其耐药性存在地区和菌种间差异，临床治疗应根据细菌药敏结果合理选用抗菌药物。
목적：료해내몽고악이다사시중심의원림상분리적장구균속세균적분포정황급대각류항균약물적내약성。방법사용 VITEK 2 compact전자동세균검측분석계통대2010년1월지2013년6월종림상표본중분리적271주장구균속세균진행균충감정화약민시험，병용 WHONET5．6연건대결과진행통계분석。결과271주장구균속세균중，시장구균137주（50．6％），분장구균80주（29．5％），기타장구균54주（19．9％）。장구균속세균주요분리자뇨액69주（25．5％）、농액40주（14．8％）、상구등분비물34주（12．5％）。분장구균대만고매소화리내서알적내약솔분별위1．3％화1．5％；미검출부남타인내약주；대청매소화안변서림적내약솔교저，분별위11．8％화2．6％；대고농도경대매소화고농도련매소적내약솔분별위31．0％화22．9％。시장구균적내약솔명현고우분장구균，대만고매소적내약솔위4．4％，미검출리내서알내약주，대부남타인적내약솔위19．1％；대고농도경대매소화고농도련매소적내약솔분별위44．8％화26．4％；단대사배소화규노보정-체복보정적내약솔저우분장구균，분별위58．3％화0。결론시장구균대항균약물적내약솔교분장구균고；병이출현대만고매소내약주；기내약성존재지구화균충간차이，림상치료응근거세균약민결과합리선용항균약물。
Objective To investigate the distribution and antimicrobial resistance in Enterococcus species isolated from Ordos Central Hospital.Methods The Enterococcus strains were isolated from clinical specimens from January 2010 to June 2013.The identification and antimicrobial susceptibility testing were completed on VITEK 2 Compact.WHONET 5.6 software was used to analyze the data.Results A total of 271 strains of Enterococcus were collected,including E.faecium (50.6%,137/271), E.faecalis (29.5%,80/271),and other Enterococcus (19.9%,54/271).The Enterococcus isolates were mainly from urine (25.5%,69/271 ),pus (14.8%,40/271 )and wound secretion (12.5%,34/271 ).The E.faecalis strains were highly susceptible to vancomycin and linezolid.Only 1 .3% and 1 .5% of the strains were resistant to vancomycin and linezolid, respectively.No strains of E.faecalis were resistant to nitrofurantoin.The percentage of E.faecalis resistant to penicillin and ampicillin was 11.8% and 2.6%,respectively.About 31.0% and 22.9% of E.faecalis strains were resistant to gentamicin (high level)and streptomycin (high level),respectively.The E.faecium strains were more resistant to most antibiotics tested than E.faecalis.The drug-resistance rate of E.faecium strains to vancomycin was 4.4%.But no strains were found resistant to linezolid.Only 19.1% of these strains were resistant to nitrofurantoin.Also 44.8% and 26.4% of E. faecium isolates were resistant to gentamicin (high level)and streptomycin (high level),respectively.However,E.faecium was less resistant to tetracycline and quinupristin-dalfopristin than E.faecalis.The resistance rate was 58.3% and 0, respectively.Conclusions The E.faecium strains are more resistant to most drugs tested than E.faecalis.Some strains are resistant to vancomycin.The resistance of Enterococcus varies widely with region and species.Antimicrobial therapy for such enterococcal infections should be based on the results of antimicrobial susceptibility testing.