臨床分離腸球菌（＂Enterococcus species＂）的菌種類別及常見菌種之藥敏型式

Speciation and Antibiogram of Clinical Enterococcus Species

林欣余(Hsin-Yu Lin) ； 楊榮勝(Rong-Sheng Yang) ； 李秀霞(Hsiu-Hsia Lee) ； 蔡文城(Wen-Cherng Tsai)

《檢驗及品保雜誌》 2卷1期 (2013/01) Pp. 39-46

https://doi.org/10.6573/JTQA.201301_2(1).05

摘要

為了瞭解台灣臨床隨機選取的腸球菌的菌種類別及常見菌種的藥敏型式，本研究利用2011至2012年臨床收集的282株腸球菌進行菌種鑑定。菌種鑑定的結果指出所收集的282株腸球菌中Enterococcusfaecalis占82.6%，Enterococcusfaecium占13.1%。其它菌種為Enterococcussulfureus、Enterococcuscolumbae、Enterococcusdispar、Enterococcuscasseliflavus、Enterococcusavium、Enterococcusraffinose和Enterococcusasinib。進一步以分離出的腸球菌E.faecalis共233株和E.faecium共37株進行瓊脂稀釋方法之藥敏試驗，根據CLSI之2012年出版的抗微生物劑感受性標準進行判讀，其中E.faecalis對penicillin、ampicillin、vancomycin及teicoplanin為感受性（susceptible, S），分別為96.6%、97.4%、98.7%及99.1%，而對tetracycline、levofloxacin之感受性為10.3%及50.6%。E.faecium對penicillin、ampicillin、levofloxacin及teicoplanin大多呈抵抗性（resistant, R），而對vancomycin、tetracycline的感受性均為81.1%，在282株中，萬古黴素抗藥性腸球菌（vancomycin-resistantEnterococcus,VRE）菌株占3.2%（9株/282株）。另外特別選取30株VRE菌株進行藥敏試驗，發現其對penicillin、ampicillin、vancomycin、teicoplanin及levofloxacin呈抵抗性（resistant, R），對tetracycline則有50%感受性，因此臨床醫師對VRE的治療，應該審慎地根據檢驗之報告選用合適抗微生物劑。

關鍵字

腸球菌 ； 菌種鑑定 ； 抗藥性

並列摘要

A total of 282 Enterococcus spp. were randomly selected from hospitalized patients from 2011 to 2012, and the species levels were identified. The susceptibilities of the frequently encountered Enterococcus spp. (Enterococcus faecalis and Enterococcus faecium) to six antimicrobials, including penicillin, ampicillin, vancomycin, teicoplanin, tetracycline, and levofloxacin were determined using the agar dilution method. Overall, 233 (81.2%) and 37 (16.7%) isolates were identified as E. faecalis and E. faecium, respectively. Others were identified as Enterococcus sulfureus, Enterococcus columbae, Enterococcus dispar, Enterococcus asinib, Enterococcus avium, Enterococcus raffinose, and Enterococcus casseliflavus. Based on the minimal inhibitory concentration interpretive standards for Enterococcus spp. published by the Clinical and Laboratory Standard Institute (CLSI M100-S22) in January 2012, E. faecalis is sensitive to penicillin, ampicillin, vancomycin, and teicoplanin but resistant to tetracycline and levofloxacin. Of the 282 Enterococcus spp., 3.2% were vancomycinresistant enterococci (VREs). In another experiment, VREs were resistant to all antimicrobials except tetracycline, which was 50% effective against VRE.

並列關鍵字

Enterococcus ； Speciation ； Antibiogram ； VRE