| Objections: Enterococci are gram-positive cocci, and are normal human flora, usually unrelated infectious disease. Enterococci has became one of the most important cause of nosocomial infection because of the abuse of drug especially the use of third generation cephalosporins, and they can be responsible for severe infections such as endocarditis, meningitis, urinary tract infection, cholecystitis, respiratory tract infection, feet infection of diabetic, surgical incision and burning infection etc. E.faecalis causes 80 to 90% of human enterococcal infection, while E.faecium infection is rarely. But in recent years , the infective ratio of Enterococcus faecium increase, and it is resistant to nearly all classes of antibacterial drugs including glycopeptides. After they were first identified in 1986,vancomycin-resistant enterococci (VRE) spread rapidly and become a major problem in many institutions both in Europe and American.Vancomycin resistance in enterococci is increasing steadily, VRE composed 26% of nosocomial enterococci in 1999,a 47% increased from 1994 to 1998. More than 25% of ICU enterococci are resistant to vancomycin. VRE are significant cause of morbidity andmortality among intensive ill patients. VRE are especially difficult organisms to treat because of their indigenous and acquired resistant to most currently available antibiotics. Up to date, so we collect 140 strains Enterococci from clinical sample , do in vitro antibacterial test of many antibiotics and anti-infectious traditional Chinese medicine ( TCMs) ,in order to observe the drug resistance chart of enterococci to antibiotics and in vitro antibacterial activity of traditional Chinese medicine and antibiotics , select drugs which have better antibacterial activity for clinical usage.Methods: identify Enterococci come from clinical samples following Sergey's manual of systematic bacterology; determine strains which products bate-lactam enzyme by nitrocefm ; select high-level aminoglyside resistance strains with M-H agar(500 ug /ml Gentamicin and 2000 Ug/ml streptomycin).(2)determine the MIC of domestic Teicoplanin and other 17 kinds of antibiotics against all the 140 strains Enterococci by two-fold agar dilution methods, the control strains is E.faecalis(ATCC33186).(3) select traditional Chinese medicine which have better antibacterial activity against 140 strains Enterococci among more than thirty ones and do quantitive antibacterial test of them in M-H agar using new methods of antibacterial experiment of traditional Chinese medicine. For example: Galla chinensis decoction: lOOg Galla chinensis into 200ml decoction with faint flame(50% decoction of Galla chinensis) for preparation.Galla chinensis alcohol extractant: add 95% alcohol into 50% decoction of Galla chinensis, the final concentration of alcohol is 75%,mixed thoroughly, sediment, retrieve alcohol, condense, dry in 3 7 癈 incubator for preparation.Results:there are 87 strains E. faecalis (62.14%),41 strains E. faecium (29.29%),9 strains E. gallinarum(6.43%), 3 strains not identified (2.14%);2 strains Enterococi which produced beta-lactam enzyme are determined by nitrocefin,the ratio is 1.43%; and there are 94 strains HLAR selected by M-H agar (500 ug/ml Gentamicin),the separative ratio is 67.1%,and 44 strains HLAR selected by M-H agar (2000 u g/ml streptomycin), the separative ratio is 31.5%.(2)the results of antibacterial test show that the antibacterial efficiency of domestic Teicoplanin and vancomycin against 140 strains Enterococci are excellent ,that of Ampicillin/sulbatam, Ampicillin, Rifomycin, Monocylin is better, and that of other antibiotics are poor.For example: the MIC50,MIC90 of domestic Teicoplanin against 87 strains E. faecalis are 0.5,1 Ug/ml, the MIC50,MIC90 against 41 strains E. faecium are all 1 ug/ml.The MIC50,MIC90 of vancomycin against E. faecalis are 1,2 ug/ml and the MIC50,MIC90 against E. faecium are 0.5,2 Ug/ml, the MIC50,MIC90 against E. gallinaum are 2,32 ug/ml, there is one strain which is resistant to vancomycin, the MIC is more th... |
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