Mihajlović Ukropina Mira, Jelesić Zora, Gusman Vera, Milosavljević Biljana
Institut za javno zdravlje Vojvodine, Novi Sad, Centar za mikrobiologiju.
Med Pregl. 2011 Sep-Oct;64(9-10):481-5. doi: 10.2298/mpns1110481m.
Enterococci are important hospital-acquired pathogens. The most commonly isolated species of the genus, Enterococcus faecalis and Enterococcus faecium are the third to fourth-most prevalent nosocomial pathogens worldwide. The aim of this study was to determine the frequency of resistance to vancomycin and other antimicrobial agents of Enterococcus spp strains isolated from blood cultures of hospitalized patients.
During the three-year period, from 2008 to 2010, 132 strains of Enterococcus spp isolated from blood cultures of hospitalized patients were tested for their susceptibility to ampicillin, vancomycin, gentamycin (high-level resistance), erythromycin, chloramphenicol, teicoplanin, ciprofloxacin by disc diffusion method according to the Clinical and Laboratory Standards Institute recommendations. Susceptibility of vancomycin resistant E. faecium to the same antibiotics and to linezolid, quinopristin/dalfopristin and tigecyclin was determined using VITEK system.
Resistance to vancomycin was detected in 21 (15.9%) Enterococcus spp strains. The percentage of resistance to other antimicrobial agents varied from 23. l% for chloramphenicol to 81.3% for ciproflxacin. All vancomycin resistant enterococci were identified as E. faecium and belonged to phenotype VanA. The resistance to other antibiotics was very high, except for linezolid and quinopristin/dalfopristin (4.7%). The high-level aminoglycoside resistance was 87.6% for gentamycin and 95.2% for streptomycin. All isolates were resistant to ampicillin, teicoplanin and ciprofloxacin.
The detected high frequency of multidrug-resistant isolates among vancomycin resistant enterococci is of great importance and suggests the need for further monitoring of susceptibility in order to take adequate measures to prevent and control spreading of resistant strains.
肠球菌是重要的医院获得性病原菌。该属中最常分离出的粪肠球菌和屎肠球菌是全球第三至第四常见的医院病原菌。本研究的目的是确定从住院患者血培养中分离出的肠球菌属菌株对万古霉素和其他抗菌药物的耐药频率。
在2008年至2010年的三年期间,根据临床和实验室标准协会的建议,采用纸片扩散法对从住院患者血培养中分离出的132株肠球菌属菌株进行了氨苄西林、万古霉素、庆大霉素(高水平耐药)、红霉素、氯霉素、替考拉宁、环丙沙星的药敏试验。使用VITEK系统测定耐万古霉素屎肠球菌对相同抗生素以及利奈唑胺、奎奴普丁/达福普汀和替加环素的敏感性。
在21株(15.9%)肠球菌属菌株中检测到对万古霉素耐药。对其他抗菌药物的耐药百分比从氯霉素的23.1%到环丙沙星的81.3%不等。所有耐万古霉素肠球菌均被鉴定为屎肠球菌,属于VanA表型。除利奈唑胺和奎奴普丁/达福普汀(4.7%)外,对其他抗生素的耐药性非常高。庆大霉素的高水平氨基糖苷类耐药率为87.6%,链霉素为95.2%。所有分离株对氨苄西林、替考拉宁和环丙沙星均耐药。
在耐万古霉素肠球菌中检测到的多药耐药分离株的高频率具有重要意义,表明需要进一步监测药敏情况,以便采取适当措施预防和控制耐药菌株的传播。