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1、肠球菌医院感染的临床特点与耐药性分析【摘要】廿的了解肠球菌医院感染的临床特点与耐药特性，以指导临床更好地开展防治工作。方法回顾性分析103例肠球菌医院感染患者的临床资料，采用MicroscanWalkAway-40全自动微生物鉴定仪鉴定菌种，K-B纸片扩散法测定抗菌药物敏感性，琼脂稀释筛检平板法筛检万古每素耐药株(VRE)与高水平氨棊糖甘类耐药株(HLAR)。结果供院感染肠球菌以粪肠球菌为主，其次是屎肠球菌，两者共占92.9%。感染部位依次为泌尿道、下呼吸道、皮肤伤口、腹腔和血液。全部患者存在严重棊础疾病，导致感染的主要危险因索是侵袭性诊疗操作、使用广谱抗牛素或激素
2、；泯合感染发牛率64.3%,病死率45.6%0丿來肠球菌的耐药性明显高于粪肠球菌，对万古霉素、替考拉宁的頌感率均＞90%oVRE与HLAR检出率分别为3.6%、71.4%0结论严重基础疾病患者更院感染肠球菌常见，主要引起泌尿道、卜呼吸道感染，冃混合感染发生率、病死率均高，临床上应引起高度重视。糖肽类抗生素仍是治疗肠球菌感染的首选药物。【关键词】肠球菌医院感染抗菌药物耐药性AnalysisofclinicalcharacteristicsandantimicrobialresistanceofEnterococcusinnosocomialinfections.ZHA
3、OFeng,ZHANGYong-biao,ZHANGKou-xing,etal.(TheThirdAffiliatedHospitalofSunYat-senUniversity,Guangzhou510630,Guangdong,P.R.China)Abstract:ObjectiveToexploretheclinicalcharacteristicsandantimicrobialresistanceofEnterococcusinnosocomialinfectionsforguidingtheprophylaxisandtreatmentinclinica
4、lpractice・MethodsClinicaldataof103casesofnosocomialinfectionswithEnterococcuswereanalyzedretrospectively,bacterialidentificationwereperformedbyMicroscanWalkAway-40system,antimicrobialsusceptibilitytestsweredonebyKirby-Bauermethod,vancomycin-resistantEnterococcus(VRE)andhigh-levelaminog
5、lycosidesresistant(HLAR)isolateswerecarriedoutbyagardilutionscreenplate(ADSP).ResultsE.faecalisandE.faeciumaccountedfor92.9%ofallEnterococcus・Infectivesiteswereurinarytract,lowerrespiratorytract,skinwound,abdominalcavityandbloodinturns.Allpatientshadsevereunderlyingdiseases.Themainrisk
6、factorsofnosocomialinfectionswithEnterococcuswereinvasivediagnosisandtreatmentmanipulation,usingbroad-spectrumantibiotics,glucocorticoids,chemotherapydrugsorimmunosuppressiveagents.Mixedinfectionandmortalityratewere64.3%and45.6%respectively.TheresistantratesofE.faeciumwereobviouslyhigh
7、erthanthatofE・faecalis,whilethesusceptibilityratesofthemicroarganismstovancomycinandteicoplaninwereover90%・VREandHLARstrainsweredetectedin3.6%and71.4%ofallEnterococcusrespectively.ConclusionNosocomialinfectionswithEnterococcusinthepatientswithsevereunderlyingdiseasesarecommon,theycau
