- 期刊
臨床常見腸球菌對常用抗微生物劑的最低抑制菌濃度
Minimal Inhibitory Concentrations of Commonly Used Antimicrobial Agents against Enterococcus Species Frequently Encountered in Hospitals
摘要
本研究利用了2013至2015年所收集的臨床240株腸球菌〔104株Enterococcus faecalis（糞腸球菌）與136株Enterococcu faecium（屎腸球菌）〕進行瓊酯稀釋方法之藥敏試驗，根據CLSI 2016年出版的抗微生物劑感受性標準進行判讀。結果發現E. faecalis對ampcillin與vancomycin的感受性分別為94.2%與86.5%，而對gentamicin與streptomycin的高濃度抗藥性(high-level resistance)為72.1% 與85.6%。至於E.faecium對ampicillin與vancomycin的感受性則分別為0%與7.3%，而對gentamicin與streptomycin的高濃度抗藥性為53.7% 與66.2%。根據上述的發現，吾等認為ampicillin與vancomycin仍對E. faecalis具有較佳的抑制性，而E. faecium則較差；兩菌之抗藥性也逐年提升。因此，臨床醫師對腸球菌感染病的治療應選用適當的抗微生物劑。另外，由於E. faecalis及E. faecium，兩者對常用抗微生物劑藥敏型式的差異，檢驗人員必需區分兩者，以協助醫師進行正確的後續治療。
並列摘要
Enterococcus species are some of the most frequently encountered pathogens in clinical laboratories. Therefore, understanding the patterns and trends of antimicrobial susceptibilities is important for the diagnosis and treatment of enterococci- infected patients by clinicians. We utilized the agar dilution method to test 240 strains of Enterococcus species (including 104 strains of Enterococcus faecalis and 136 strains of E. faecium) isolated between 2013 and 2015. The minimal inhibitory concentrations (MICs) of various antimicrobial agents against these organisms were interpreted according to the guidelines of the 2016 M100-S26, CLSI. The results indicated that for the E. faecalis strains, the susceptibility rates to ampicillin and vancomycin were 94.2% and 86.5%, respectively, whereas their resistance rates to high-level gentamicin and streptomycin were 72.1% and 85.6%, respectively. For the E. facium strains, the susceptibility rates to ampicillin and vancomycin were 0% and 7.3%, respectively, whereas their resistance rates to high-level gentamicin and streptomycin were 53.7% and 66.2%, respectively. Based on the above findings, we concluded that the inhibitory capabilities of ampicillin and vancomycin against E. faecalis are better than their inhibitory capabilities against E. faecium. At the same time, a trend of increasing drug resistance was evident in both organisms. Due to the fact that the antibiograms of these two organisms are different, it will be necessary to differentiate between these two organisms in order to assist the accurate follow-up treatment of patients by clinicians.