CAJ | 학술논문

目的：了解临床感染肠球菌的分布特征及耐药性的变迁，为临床治疗提供参考。方法对2011—2014年我院各类临床标本分离出的485株肠球菌的分布特征和耐药情况进行回顾性分析。结果本研究肠球菌属中以粪肠球菌所占比例最高（53．19%)，屎肠球菌次之（40．41%)。肠球菌属在尿液标本中检出率最高（70．31%)，其次为伤口分泌物（14．43%)。肠球菌总体耐药水平较高，仅对万古霉索、呋喃妥因、氯霉素较为敏感。2014年与2011年相比，粪肠球菌对青霉素、氨苄西林、利福平、呋喃妥因的耐药率显著降低，差异具有统计学意义（P<0．05或P<0．01)；而屎肠球菌基本无变化，仅对四环素和高浓度庆大霉素耐药率降低，差异具有统计学意义（ P<0．01)。结论肠球菌属感染以粪肠球菌、屎肠球菌为主；肠球菌属总体耐药率较高，屎肠球菌耐药性高于粪肠球菌。临床治疗应根据药物敏感试验结果合理应用抗菌药物，同时应采取必要的预防措施以降低耐药性。
목적：료해림상감염장구균적분포특정급내약성적변천，위림상치료제공삼고。방법대2011—2014년아원각류림상표본분리출적485주장구균적분포특정화내약정황진행회고성분석。결과본연구장구균속중이분장구균소점비례최고（53．19%)，시장구균차지（40．41%)。장구균속재뇨액표본중검출솔최고（70．31%)，기차위상구분비물（14．43%)。장구균총체내약수평교고，부대만고매색、부남타인、록매소교위민감。2014년여2011년상비，분장구균대청매소、안변서림、리복평、부남타인적내약솔현저강저，차이구유통계학의의（P<0．05혹P<0．01)；이시장구균기본무변화，부대사배소화고농도경대매소내약솔강저，차이구유통계학의의（ P<0．01)。결론장구균속감염이분장구균、시장구균위주；장구균속총체내약솔교고，시장구균내약성고우분장구균。림상치료응근거약물민감시험결과합리응용항균약물，동시응채취필요적예방조시이강저내약성。
Objective To investigate the characteristics of distribution and the change in drug resistance of Entero-coccus to provide reference for clinical therapy. Methods The distribution and drug resistance of 485 strains of enterococci i-solated from various clinical specimens of the infections during 2011 and 2014 were retrospectively analyzed. Results Among the 485 strains of enterococci in the study, the top organism was enterococcus faecalis (53. 19%), the second was enterococ-cusfaecium (40. 41%). The main localities from the enterococci isolated were urinary tract (70. 31%), followed by secretion (14. 43%). Enterococci strains were resistant to multiple antibiotics, but sensitive to Vancomycin, Nitrofurantoin and Chlor-amphenicol. Compared with the drug resistance rates of enterococcusfaecalis to Penicillin, Ampicillin, Rifampicin and Nitro-furantoin in 2011, they were significantly decreased in 2014 (P<0. 05 or P<0. 01), and the drug resistance rates of entero-coccusfaecium to Tetracycline and high level of Gentamicin were significantly decreased in 2014 (P<0. 01). Conclusion The most common enterococci causing hospital infection are enterococcus faecalis and enterococcus faecium. The drug resist-ance rate of enterococcusfaecium is higher than that of enterococcus faecalis. The antibacterial agents should be reasonably ap-plied according to antimicrobial susceptibility test during clinical therapy. Furthermore, necessary steps should be taken to prevent the enterococcal infection and reduce the drug resistance.