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首页> 外文期刊>Journal of Clinical Microbiology >Enterococci highly resistant to penicillin and ampicillin: an emerging clinical problem?
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Enterococci highly resistant to penicillin and ampicillin: an emerging clinical problem?

机译：肠球菌对青霉素和氨苄青霉素具有高度耐药性：一个正在出现的临床问题？

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Sixteen clinical isolates of ampicillin-resistant enterococci (ARE) were recovered from the microbiology laboratory of a 450-bed rehabilitation medical center from January 1981 to September 1987. These isolates were detected when a disk diffusion test using 10 micrograms of ampicillin on a blood agar plate revealed no zones of inhibition. Tube macrodilution tests yielded an MIC of greater than or equal to 16 micrograms of ampicillin per ml. None of the isolates were penicillinase producers by the chromogenic cephalosporin disk test. Ten isolates were Enterococcus faecium, four isolates were E. raffinosus, one isolate was E. gallinarum, and one isolate was not identified (lost). There were 6 male and 10 female patients. The sources of isolates were urine (n = 7), wound (n = 5), ascitic fluid (n = 2), blood (n = 2), peritoneal catheter tip (n = 1), Bartholin's cyst abscess (n = 1), rectal swab (n = 2), and pancreatic abscess (n = 1). The organism was isolated from multiple sites in 4 patients, was a pure culture isolate in 5 patients, and was part of a polymicrobial flora in 11 patients. Six patients were diabetic, and four had liver cirrhosis. All but four patients had received at least one antibiotic within 3 weeks of ARE isolation. The MICs (micrograms per milliliter) for 50 and 90% of isolates tested, respectively, were as follows: ampicillin, 64 and 64; penicillin, 128 and greater than 128; vancomycin, 1 and 2; gentamicin, 4 and 16; ciprofloxacin, 1.6 and 3.2; imipenem, 128 and greater than 128; and daptomycin (LY146032), 1.6 and 6.4. ARE may be an emerging pathogen in the hospitalized patient population.
机译：从1981年1月至1987年9月，从一个有450张床的康复医学中心的微生物实验室中回收了16株氨苄青霉素耐药肠球菌（ARE）临床分离株。当在血琼脂上使用10微克氨苄青霉素进行磁盘扩散试验时，检测到这些分离株。平板显示没有抑制区域。试管大稀释试验得出的MIC大于或等于16微克氨苄青霉素/毫升。通过发色性头孢菌素盘试验，分离株都不是青霉素酶的产生者。十株为粪肠球菌，四株为葡萄球菌，一株为鸡肠球菌，一株未鉴定（丢失）。男6例，女10例。分离株的来源是尿液（n = 7），伤口（n = 5），腹水（n = 2），血液（n = 2），腹膜导管尖端（n = 1），巴尔索林的囊肿脓肿（n = 1） ），直肠拭子（n = 2）和胰腺脓肿（n = 1）。该微生物是从4例患者的多个部位分离出来的，是5例患者的纯培养物分离物，并且是11例患者的多菌群的一部分。糖尿病患者6例，肝硬化4例。除四名患者外，所有患者在ARE隔离后3周内均接受了至少一种抗生素。分别对50％和90％的分离株的MIC（每毫升微克）如下：氨苄青霉素64和64;氨苄西林64和64。青霉素128和大于128;万古霉素1和2;庆大霉素4和16;环丙沙星1.6和3.2;亚胺培南128和大于128;和达托霉素（LY146032），1.6和6.4。 ARE可能是住院患者人群中的新兴病原体。

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