肠球菌的耐药性分析
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摘要
目的了解惠州市中心人民医院肠球菌的分布及耐药情况,并对危险因素进行分析,为指导临床合理应用抗菌药物提供依据。方法回顾性分析2013～2017年该院分离肠球菌的耐药率及其与多种抗菌药DDDs的相关性,并分析其潜在的危险因素。结果肠球菌主要来源于脓液及创口分泌物标本;医院肠球菌对各监测药物的耐药情况总体比较稳定,耐万古霉素肠球菌处于较低水平;大多数肠球菌的耐药性与抗菌药DDDs之间无显著相关性。结论应进一步加强医院抗菌药物的使用管理,规范抗菌药物的使用,降低肠球菌的耐药率。
Objective To investigate the distribution and resistance of Enterococcusin Huizhou Municipal Central Hospital,and to analyze the risk factors,so as to provide evidences for clinical reasonable application of antibiotics.Methods The resistant rates of Enterococcusisolated from 2013 to 2017were retrospectively analyzed,and its correlation with DDDs of variety antibacterials,and potential risk factors were analyzed.Results Enterococcus were mainly from pus and wound secretions.The drug resistance of the hospital Enterococcus to each monitoring drug was relatively stable,and vancomycin resistant Enterococcus was at a lower level.There was no significant correlation between the resistance of most Enterococcus and the antibacterials DDDs.Conclusion We should further strengthen the management of antimicrobial appliation in hospitals,standardize the use of glycopeptides and penicillins,and reduce the drug resistance rate of Enterococcus.
Objective To investigate the distribution and resistance of Enterococcusin Huizhou Municipal Central Hospital,and to analyze the risk factors,so as to provide evidences for clinical reasonable application of antibiotics.Methods The resistant rates of Enterococcusisolated from 2013 to 2017were retrospectively analyzed,and its correlation with DDDs of variety antibacterials,and potential risk factors were analyzed.Results Enterococcus were mainly from pus and wound secretions.The drug resistance of the hospital Enterococcus to each monitoring drug was relatively stable,and vancomycin resistant Enterococcus was at a lower level.There was no significant correlation between the resistance of most Enterococcus and the antibacterials DDDs.Conclusion We should further strengthen the management of antimicrobial appliation in hospitals,standardize the use of glycopeptides and penicillins,and reduce the drug resistance rate of Enterococcus.
引文
[1] Sharifi Y,Hasani A,Ghotaslou R,et al.Virulence and antimicrobial resistance in Enterococci isolated from urinary tract infections[J].Adv Pharm Bulletin,2013,3(1):197-201.
[2] Murray B E.Vancomycin-resistant enterococcal infections[J].New England J Med,2000,342:710-721.
[3]叶应妩,王毓三,申子瑜,等.全国检验操作规程[M].3版.南京:东南大学出版社,2008:68-69.
[4]许宏涛,张秀珍.2004年美国临床实验室标准化委员会药敏试验判断标准[J].中国临床药理学杂志,2005,21(4):318-320.
[5]薛薇.SPSS统计分析方法及应用[M].北京:电子工业出版社,2006:237.
[6]李耘,吕媛,郑波,等.中国细菌耐药监测研究2015-2016革兰氏阳性菌监测报告[J].中国临床药理学杂志,2017,33(23):2543-2556.
[7]李娟,李文红,韩雪,等.肠球菌属临床分布特征与耐药性分析[J].中华医院感染学杂志,2016,26(1):26-27,33.
[8]杨青,俞云松,林洁,等.2005-2014年CHINET肠球菌属细菌耐药性监测[J].中国感染与化疗杂志,2016,16(2):146-152.
[9]李芳,曾晓艳,仝晓宁,等.泌尿系感染病原菌的分布及耐药性分析[J].西北药学杂志,2016,31(5):528-531.
[10]涂昕睿,褚云卓,阎东莉,等.肠球菌属医院感染的危险因素与耐药性分析[J].中华医院感染学杂志,2015,25(7):1457-1458,1532.
[11]Kilbas I,Ciftci I H.Antimicrobial resistance of Enterococcusin Turkey:a Meta-analysis of current studies[J].J Glob Antimicrob Resist,2018,12:26-30.
[12]赵淑慧.耐万古霉素肠球菌感染的临床分析[J].西北药学杂志,2014,29(3):287-289.
[13]李六亿,陈美恋,吴安华,等.耐万古霉素肠球菌感染流行病学多中心研究[J].中国感染控制杂志,2015,14(8):518-523.
[14]国家卫生计生委合理用药专家委员会,全国细菌耐药监测网.2014年全国细菌耐药监测报告[J].中国执业药师,2016,13(2):3-8.
[15]国家卫生计生委合理用药专家委员会,全国细菌耐药监测网.2015年全国细菌耐药监测报告[J].中国执业药师,2016,13(3):3-8.
[16]徐丹,李耘,朱赛楠,等.2004-2014年尿标本分离粪肠球菌和屎肠球菌药物敏感性变迁[J].中国感染控制杂志,2017,16(4):322-325.
[17]马承泰,石磊,陈小雪,等.急诊科肠球菌尿路感染的临床危险因素分析[J].齐鲁医学杂志,2016,31(5):556-558.
[18]Dietrich J N,Faine B A,Mohr N M.Vancomycin-resistant Enterococcus colonization does not accurately predict resistant Enterococcus infections[J].J Crit Care,2017,38:236.
[2] Murray B E.Vancomycin-resistant enterococcal infections[J].New England J Med,2000,342:710-721.
[3]叶应妩,王毓三,申子瑜,等.全国检验操作规程[M].3版.南京:东南大学出版社,2008:68-69.
[4]许宏涛,张秀珍.2004年美国临床实验室标准化委员会药敏试验判断标准[J].中国临床药理学杂志,2005,21(4):318-320.
[5]薛薇.SPSS统计分析方法及应用[M].北京:电子工业出版社,2006:237.
[6]李耘,吕媛,郑波,等.中国细菌耐药监测研究2015-2016革兰氏阳性菌监测报告[J].中国临床药理学杂志,2017,33(23):2543-2556.
[7]李娟,李文红,韩雪,等.肠球菌属临床分布特征与耐药性分析[J].中华医院感染学杂志,2016,26(1):26-27,33.
[8]杨青,俞云松,林洁,等.2005-2014年CHINET肠球菌属细菌耐药性监测[J].中国感染与化疗杂志,2016,16(2):146-152.
[9]李芳,曾晓艳,仝晓宁,等.泌尿系感染病原菌的分布及耐药性分析[J].西北药学杂志,2016,31(5):528-531.
[10]涂昕睿,褚云卓,阎东莉,等.肠球菌属医院感染的危险因素与耐药性分析[J].中华医院感染学杂志,2015,25(7):1457-1458,1532.
[11]Kilbas I,Ciftci I H.Antimicrobial resistance of Enterococcusin Turkey:a Meta-analysis of current studies[J].J Glob Antimicrob Resist,2018,12:26-30.
[12]赵淑慧.耐万古霉素肠球菌感染的临床分析[J].西北药学杂志,2014,29(3):287-289.
[13]李六亿,陈美恋,吴安华,等.耐万古霉素肠球菌感染流行病学多中心研究[J].中国感染控制杂志,2015,14(8):518-523.
[14]国家卫生计生委合理用药专家委员会,全国细菌耐药监测网.2014年全国细菌耐药监测报告[J].中国执业药师,2016,13(2):3-8.
[15]国家卫生计生委合理用药专家委员会,全国细菌耐药监测网.2015年全国细菌耐药监测报告[J].中国执业药师,2016,13(3):3-8.
[16]徐丹,李耘,朱赛楠,等.2004-2014年尿标本分离粪肠球菌和屎肠球菌药物敏感性变迁[J].中国感染控制杂志,2017,16(4):322-325.
[17]马承泰,石磊,陈小雪,等.急诊科肠球菌尿路感染的临床危险因素分析[J].齐鲁医学杂志,2016,31(5):556-558.
[18]Dietrich J N,Faine B A,Mohr N M.Vancomycin-resistant Enterococcus colonization does not accurately predict resistant Enterococcus infections[J].J Crit Care,2017,38:236.