摘要
目的分析呼和浩特市第一医院肠球菌的检出率和标本来源分布及耐药性,为临床医师正确应用抗菌药物提供依据。方法回顾性分析2015—2020年呼和浩特市第一医院住院及门诊患者分离的肠球菌的检出率、标本分布及其耐药情况。结果2015—2020年共分离出1697株肠球菌,其中粪肠球菌为33.64%,屎肠球菌为63.70%,其他肠球菌为2.65%。2015—2020年肠球菌分离率总体呈缓慢上升趋势,粪肠球菌和屎肠球菌分离率无显著变化。粪肠球菌在中段尿、分泌物和全血的分离率较高;屎肠球菌在中段尿、全血和腹水的分离率较高。2015—2020年粪肠球菌对利奈唑胺、万古霉素、呋喃妥因、青霉素、氨苄西林的耐药率均呈现出较低水平,对喹诺酮类的耐药率在26.14%~52.12%,对大环内酯类保持较高的耐药率;屎肠球菌对奎奴普汀/达福普汀、利奈唑胺和万古霉素的耐药率低,而对其他常规使用抗菌药物的耐药率较高。2015—2020年屎肠球菌对除万古霉素之外其他种抗菌药物耐药率明显高于粪肠球菌(P<0.05)。2015—2020年共检出31株万古霉素耐药肠球菌(VRE),22株屎肠球菌、9株粪肠球菌。结论肠球菌分离率总体呈上升趋势,耐药菌株的分离率较高,故临床医生应结合患者自身情况、致病菌的药物敏感性试验结果及抗菌药物的药代动力学,在保证患者治疗效果的前提下应阻止多重耐药菌的院内感染。
Objective To analyze the detection rate,sample source distribution and drug resistance of enterococci in the Hohhot First Hospital,so as to provide a basis for clinical rational use of antibiotics.Methods The distribution,sample source and drug resistance of enterococci isolated from all clinical departments of the Hohhot First Hospital from 2015 to 2020 were analyzed retrospectively.Results A total of 1697 strains of enterococci were detected from 2015 to 2020,of which 33.64%were enterococcus faecalis,63.70%were enterococcus faecium and 2.65%were other enterococci.From 2015 to 2020,the detection rate of enterococci showed an upward trend on the whole,while there were no significant changes in the detection rates of enterococcus faecalis and enterococcus faecium.The first three sample sources of enterococcus faecalis were urine,secretion and blood.The first three sample sources of enterococcus faecium were urine,blood and ascites.From 2015 to 2020,enterococcus faecalis showed relatively low drug resistance to all of penicillin,ampicillin,nitrofurantoin,linezolid and vancomycin.The drug resistance rate to quinolones fluctuated between 26.14%and 52.12%.The drug resistance to erythromycin was relatively high,which remained above 66.17%.Enterococcus faecium showed relatively low drug resistance to linezolid,vancomycin and quinupristin/dalfopristin,but relatively high drug resistance to another 10 antibiotics.From 2015 to 2020,the drug resistance of enterococcus faecium to 10 antibiotics except vancomycin was significantly higher than that of enterococcus faecalis(P<0.05).A total of 31 strains of vancomycin-resistant enterococci(VRE)were detected from 2015 to 2020,including 22 strains of enterococcus faecium and 9 strains of enterococcus faecalis.Conclusion On the whole,the detection rate of enterococci shows a rising trend,and the drug resistance is relatively serious.Therefore,clinicians should rationally use antibiotics according to the results of drug sensitivity of pathogenic bacteria,patients’own situation and pharmacokinetics,so as to ensure the therapeutic efficacy of patients and simultaneously curb the spread of multi-drug-resistant bacteria or even outbreaks.
作者
巴林其木格
董海荣
Balinqimuge;DONG Hairong(Department of Clinical Laboratory,Hohhot First Hospital,Inner Mongolia,Hohhot 010010,China)
出处
《中国医药科学》
2022年第14期118-121,共4页
China Medicine And Pharmacy
关键词
肠球菌
粪肠球菌
屎肠球菌
耐药率
Enterococci
Enterococcus faecalis
Enterococcus faecium
Drug resistance rate
