论文部分内容阅读
目的研究粪肠球菌和屎肠球菌致重症患者尿路感染现状并对其耐药特征进行比较分析,为临床合理选用抗菌药物,有效预防和控制感染提供依据。方法对2011年1月至2014年12月福建医科大学附属第二医院重症监护室尿路感染患者分离的172株肠球菌进行分析,用法国生物梅里埃Vitek2-Compact微生物鉴定仪鉴定肠球菌,K-B纸片扩散法进行药敏试验,利用WHONET 5.6软件分析处理试验数据。结果 172株肠球菌中,粪肠球菌和屎肠球菌分别占68.0%和32.0%;药敏试验表明两种肠球菌对利奈唑胺、万古霉素、替考拉宁都较敏感(耐药率<5.0%),未检出对替加环素耐药的菌株,除这4种药物外,对其余12种抗菌药物差异存在统计学意义(χ2=36.15,P<0.05)。4年间粪肠球菌除对四环素、替加环素外,屎肠球菌除对四环素、庆大霉素(高浓度)、替加环素外,对其余抗菌药物的耐药率的变化均呈显著升高的趋势(χ2=16.71,P<0.05)。结论从该院重症患者尿液标本中分离出的肠球菌多重耐药严重,对大多数抗菌药物的耐药率呈逐年升高的趋势,两种肠球菌的耐药性存在菌种差异,临床应加强细菌监测,治疗肠球菌感染时首选利奈唑胺、万古霉素、替考拉宁、替加环素。
Objective To study the status of urinary tract infection in critically ill patients with Enterococcus faecalis and Enterococcus faecium and to compare and analyze the characteristics of urinary tract infection in order to provide a basis for clinical rational use of antibacterial drugs and effective prevention and control of infection. Methods A total of 172 strains of enterococci isolated from patients with urinary tract infection in ICU of the Second Affiliated Hospital of Fujian Medical University from January 2011 to December 2014 were analyzed. Enterococci were identified by the Vitek2-Compact Microbial Identification System Disk diffusion method for susceptibility testing, the use of WHONET 5.6 software analysis and processing of experimental data. Results Enterococcus faecalis and Enterococcus faecium accounted for 68.0% and 32.0% of the 172 enterococci, respectively. Susceptibility tests showed that both enterococci were more sensitive to linezolid, vancomycin and teicoplanin (resistance rate < 5.0%). No strains resistant to tigecycline were detected except for the four drugs (χ2 = 36.15, P <0.05). Enterococcus faecalis in addition to tetracycline, tigecycline, Enterococcus faecium in addition to tetracycline, gentamicin (high concentration), tigecycline, the remaining antimicrobial resistance rates were significantly changed Increasing trend (χ2 = 16.71, P <0.05). Conclusion Enterococci isolated from urine samples of critically ill patients in this hospital have serious multi-drug resistance. The resistance rate to most antibiotics shows a trend of increasing year by year. The two strains of enterococci are different in their drug resistance. Clinical Should strengthen the monitoring of bacteria, treatment of Enterococci preferred linezolid, vancomycin, teicoplanin, tigecycline.