Clinical Distribution and Drug Resistance of Enterococcus in Our Hospital from Jan. 2009 to Jun. 2017 / 中国药房

ABSTRACT

OBJECTIVE:To provide reference for hospital infection treatment and control. METHODS:The etiological data of Enterococcus isolated from clinical specimens were collected from our hospital during Jan. 2009-Jun. 2017. The drug resistance of commonly used antibiotics and infection related risk factors were analyzed retrospectively. RESULTS:A total of 6252 isolates of Enterococcus were isolated,of which there were 1994 strains of E. faecalis and 3575 strains of E. faecium. The bacteria were mainly isolated from urine(2009 strains),drainage liquids(1538 strains),bile(1168 strains),wound secretions(561 strains), blood (493 strains). The detection rate increased 9.4％ in 2009 to 13.4％ in 2017. Resistance rate of E. faecalis to ampicillin, penicillin and vancomycin showed a wavelike decrease,and E. faecalis showed low resistance rate to vancomycin,teicoplanin, linezolid and tigecycline. Resistance rate of E. faecalis to ciprofloxacin,moxifloxacin and levofloxacin decreased wavily to 2014 but showed a fluctuating upward trend since 2015. Resistance rate of E. faecium to linezolid decreased from 1.9％ in 2009 to 0.2％ in Jun. 2017;resistance rate of E. faecium to vancomycin and teicoplanin continues to fluctuate,but it is still at a low level;resistance rate of E. faecium to tetracycline decreased, but that to high concentration gentamicin increased. There were 43 strains of vancomycin-resistant E. faecium and 8 trains of vancomycin-resistant E. faecalis detected in 51 patients. Resistant rates of vancomycin-resistant E. faecium to linezolid,tigecycline and teicoplanin were 23.3％,0,35.3％,respectively. Resistant rates of vancomycin-resistant E. faecalis to linezolid,tigecycline and teicoplanin were 0. Pearson relationship analysis showed that days in ICU (r=0.225,P<0.01),tracheotomy or intubation (r=0.314,P<0.01),days of antibiotic use (r=0.347,P<0.01),types of antibacterial drugs (r=0.226,P<0.01),use of glucocorticoids (r=0.190,P<0.01),and days of carbapenems use (r=0.173,P<0.05)were positively correlated with vancomycin-resistant E. faecium infection rate and vancomycin-resistant E. faecalis infection rate. CONCLUSIONS:The detection rate of Enterococcus in our hospital is fluctuating upward. E. faecalis and E. faecium were the main types,mainly from urine and drainage fluids. The resistance rate of Enterococcus most of antibiotics shows a downward trend. The resistance rate of E. faecium to high concentration gentamycin is on the rise,while that of E. faecium to linezolid and tetracycline is decreased. The appropriate antibiotics should be selected according to the patient's condition and drug susceptibility results.