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目的分析重型肝炎患者肠球菌感染的现状及体外药敏特点。方法采集重型肝炎患者的各类标本做细菌培养,并测定对常用抗菌药物的敏感性。结果所有纳入研究范围的重型肝炎患者共检出肠球菌112株,其中粪肠球菌 89株,比例最高,占79．5％,屎肠球菌16株,占14．3％,居第二位。腹水中肠球菌检出率最高,达到57．1％。检出高耐庆大霉素肠球菌58株,占51．8％,耐氨苄西林肠球菌19株,占17．0％,多重耐药(庆大霉素高水平耐药合并氨苄西林耐药)肠球菌7株,占6．3％。肠球菌对万古霉素和替考拉宁的敏感率最高,分别达到96．4％和100％。未检出耐万古霉素肠球菌,但检出万古霉素中介肠球菌4株,占3．6％。结论肠球菌是重型肝炎患者感染的重要致病菌,尤以粪肠球菌为主。并发肠球菌感染时,应高度重视细菌培养和药敏实验,为合理抗菌治疗提供依据。万古霉素和替考拉宁是治疗肠球菌感染的首选药物。
Objective To analyze the status of enterococcal infection in patients with severe hepatitis and the drug susceptibility characteristics in vitro. Methods All kinds of specimens of patients with severe hepatitis were collected for bacterial culture and the sensitivity to commonly used antibiotics was determined. Results A total of 112 enterococci were detected in all the patients with severe hepatitis, of which 89 strains were Enterococcus faecalis, accounting for the highest proportion of 79.5% and 16 strains of Enterococcus faecium accounting for 14.3%. Ascites in the highest detection rate of enterococci, reaching 57.1%. 58 strains of gentamicin-resistant enterococci were detected, accounting for 51.8%, 19 strains resistant to ampicillin, accounting for 17.0%, and multi-drug resistant (high level of gentamicin combined with ampicillin-resistant ) Enterococci 7 strains, accounting for 6.3%. The highest sensitivity rates of enterococci to vancomycin and teicoplanin were 96.4% and 100% respectively. No vancomycin-resistant enterococci were detected, but 4 strains of vancomycin-producing enterococci were detected, accounting for 3.6%. Conclusion Enterococcus is an important pathogen of severe hepatitis infection, especially Enterococcus faecalis. Concurrent enterococci infection, should attach great importance to bacterial culture and susceptibility testing, to provide a basis for rational antibacterial therapy. Vancomycin and teicoplanin are the drugs of choice for the treatment of enterococcal infections.