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目的对不同标本来源的肠球菌临床资料进行分析,了解其耐药分布及变迁趋势,为临床治疗不同部位肠球菌感染提供依据。方法收集2015至2016年6月检出肠球菌3 237株,对其标本分布特征及不同标本类型肠球菌耐药情况进行统计分析。结果分离出屎肠球菌1 870株,粪肠球菌1 367株。标本分布类型为尿液42%,分泌物21%,血培养19%,腹水胆汁18%。不同标本类型屎肠球菌及粪肠球菌对常用抗菌药物耐药情况较严重,除四环素和利奈唑胺,屎肠球菌对常用抗菌药物整体耐药率明显高于粪肠球菌。屎肠球菌中尿液标本整体耐药率显著高于其他组(P<0.05),粪肠球菌中腹水、胆汁标本整体耐药率较低(P<0.05)。不同标本类型肠球菌对多种常用抗菌药物耐药率差异较明显,差异有统计学意义(P<0.05)。结论肠球菌引起的感染耐药情况严重,临床治疗肠球菌感染时,应根据菌种差异、不同标本类型反应的不同感染部位,合理选用抗菌药物。
Objective To analyze the clinical data of enterococci from different samples to understand their drug resistance distribution and trend of change and provide basis for clinical treatment of enterococcal infection in different parts. Methods A total of 3 237 enterococci were collected from June 2015 to June 2016. Their distribution characteristics and drug resistance of different types of enterococci were statistically analyzed. Results A total of 1 870 Enterococcus faecium and 1 367 Enterococcus faecalis were isolated. Specimens were classified as 42% urine, 21% secretions, 19% blood culture and ascites bile 18%. Different specimen types Enterococcus faecalis and Enterococcus faecalis commonly used antimicrobial resistance is more serious, except for tetracycline and linezolid, Enterococcus faecium common antibacterial drug resistance rates were significantly higher than Enterococcus faecalis. Enterococcus faecium urine samples overall resistance was significantly higher than the other groups (P <0.05), Enterococcus faecalis in ascites, bile specimens overall resistance rate was lower (P <0.05). The differences of drug resistance rates of different types of enterococci between various commonly used antibiotics were significant (P <0.05). Conclusions Enterococci cause serious resistance to infection. In clinical treatment of enterococcal infection, antibiotics should be selected reasonably according to different species and different types of specimens.