血培养分离肠球菌属细菌的分布及耐药性

Distribution and antimicrobial resistance of Enterococcus spp. isolated from blood culture

摘要:

目的了解血培养中肠球菌属细菌的临床分布特点及耐药性。方法分析某院2012年1月—2016年12月住院患者血培养标本分离出的肠球菌属细菌情况，并对其药敏结果进行统计分析。结果共分离肠球菌属细菌139株，其中屎肠球菌78株，粪肠球菌60株，鸟肠球菌1株，分别占56.11%、43.17%及0.72%；年龄分布以＞60岁及≤28 d患者为主，分别占56.83%和17.27%。主要来源科室为重症监护病房（ICU）及新生儿科，分别占34.53%和18.70%。鸟肠球菌仅有1株，分离自新生儿科。屎肠球菌对青霉素、氨苄西林、左氧氟沙星、环丙沙星、莫西沙星及呋喃妥因的耐药率高于粪肠球菌（均P＜0.05）；但对四环素的耐药率低于粪肠球菌（P=0.001）。屎肠球菌对万古霉素和利奈唑胺的耐药率分别为2.56%、6.41%；粪肠球菌对万古霉素和利奈唑胺的耐药率为0及3.33%。结论血培养中肠球菌属细菌以屎肠球菌和粪肠球菌为主，老年人及新生儿为主要分离人群。屎肠球菌对多数抗菌药物的耐药率高于粪肠球菌，但两者对利奈唑胺的耐药率均高于万古霉素，需继续重点监测。

Abstract:

ObjectiveTo understand the clinical distribution and antimicrobial resistance of Enterococcus spp. isolated from blood culture. MethodsEnterococcus spp. isolated from blood culture specimens of hospitalized patients between January 2012 and December 2016 was analyzed, antimicrobial susceptibility testing results were analyzed. ResultsA total of 139 strains of Enterococcus spp. were isolated, including 78 strains of Enterococcus faecium (E. faecium), 60 Enterococcus faecalis (E. faecalis), and 1 Enterococcus avium(E. avium), accounting for 56.11%, 43.17%, and 0.72% respectively; 56.83% of patients were >60 years and 17.27% were ≤28 days. The main department sources of strains were intensive care unit and neonatal department, accounting for 34.53% and 18.70% respectively. There was only 1 strain of E. avium, which was isolated from neonatal department. Resistance rates of E. faecium to penicillin, ampicillin, levofloxacin, ciprofloxacin, moxifloxacin, and nitrofurantoin were all higher than E. faecalis（all P＜0.05）, while resistance rate to tetracycline was lower than E. faecalis（P=0.001）. Resistance rates of E. faecium to vancomycin and linezolid were 2.56% and 6.41% respectively; resistance rates of E. faecalis to vancomycin and linezolid were 0 and 3.33% respectively. ConclusionE. faecium and E. faecalis are the main Enterococcus spp. isolated from blood culture, most are isolated from the elderly patients and newborns. Resistance rates of E. faecium to most antimicrobial agents are higher than E. faecalis, resistance rates of E. faecium and E. faecalis to linezolid are both higher than resistance rates to vancomycin, key monitoring needs to be continued.