摘要
目的测定葡萄球菌属对红霉素及克林霉素的耐药性,分析红霉素诱导克林霉素耐药的发生率以及耐药基因的类型。方法用K-B法检测葡萄球菌属对红霉素及克林霉素的耐药性,依据NCCLS 2004年发布M100-S14的D-试验方法,测定红霉素对克林霉素的诱导耐药表型,采用聚合酶链反应(PCR)技术检测msrA、Vgb、sat4、ermA、ermB、ermC耐药基因。结果耐甲氧西林金黄色葡萄球菌和耐甲氧西林凝固酶阴性葡萄球菌对红霉素及克林霉素同时耐药分别占80.00%和54.17%;D-试验阳性占所检测葡萄球菌属的26.15%,占红霉素耐药而克林霉素敏感菌株的68.00%;对红霉素耐药而克林霉素敏感的金黄色葡萄球菌和凝固酶阴性葡萄球菌中,D-试验阳性即对克林霉素具有诱导耐药性者分别为75.00%和65.88%;耐药基因分析表明:红霉素核糖体甲基化酶基因ermC是诱导耐药的主要基因,占检出耐药基因的76.47%;ermC+sat4基因的检出率为8.82%。结论临床微生物实验室应开展D-试验,检测葡萄球菌属中红霉素对克林霉素的诱导耐药,指导临床医生更合理使用抗菌药物。
OBJECTIVE To detect the resistance of Staphylococcus to erythromycin and clindamycin, and analyze the prevalence of inducible resistance of erythromycin to clindamycin and resistance gene in Staphylococcus. METHODS The susceptibilities to erythromycin and clindamycin for Staphylococcus were examined by Kirby-Bauer disc agar diffusion test and the inducible resistance of erythromycin to clindamycin was checked by D-test according to the standards of NCCLS （2004, M100-S14）. msrA, Vgb, sat4, ermA, ermB And ermC resistance genes were detected by using PCR technology. RESULTS Co-resistance to erythromycin and clindamycin accounted for 80. 00% and 54. 17% in MRSA and MRCNS, respectively. The rate of D-test positive was 26.15% among all Staphylococcus tested, and it was 68.00% among the erythromycin resistant and clindamycin sensitive Staphylococcus. The D-test positive rate of inducible resistance to clindamycin was 75.00% and 65.88% in Staphylococcus aureus and coagulase-negative Staphylococcus which were erythromycin resistant and clindamycin sensitive by individual disk diffusion test. The errnC gene was the main one for inducible resistance of erythromycin to clindamycin. The percentage of ermC gene was 76.47% and that of ermC＋sat4 was 8. 82%. CONCLUSIONS The inducible resistance of erythromycin to clindamycin in Staphylococcus should be detected by D-test in clinical microbiology laboratory in order to guide physicians to select reasonable antibiotics for Staphylococcus infection.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2007年第2期121-124,共4页
Chinese Journal of Nosocomiology
基金
深圳市科技计划重大项目(JH200505260279A)
