摘要
目的调查医院金黄色葡萄球菌临床分离株对大环内酯类(红霉素)、林可酰胺类(克林霉素)和链阳霉素B类(MLSB)抗菌药物的耐药性,检测克林霉素诱导耐药的发生情况及耐药菌株的耐药相关基因。方法单一纸片扩散法检测金黄色葡萄球菌对红霉素和克林霉素的耐药性,再以D-试验检测红霉素诱导克林霉素耐药表型;PCR反应检测各耐药菌株的红霉素耐药相关基因。结果临床分离的金黄色葡萄球菌对红霉素和克林霉素的耐药率分别为80.3%和70.2%,对两者同时耐药(结构型MLSB耐药)的菌株占70.2%;克林霉素诱导耐药(D-试验阳性)菌株占所检测菌株的9.6%,占红霉素耐药、克林霉素敏感菌株的95.5%;在所有的红霉素耐药菌株中检出ermA、ermC和msrA基因。结论医院感染金黄色葡萄球菌对MLSB类抗菌药物的耐药性比较严重;在红霉素耐药、克林霉素敏感菌株中克林霉素诱导耐药率很高,临床实验室对该类菌株必须进行D-试验,以指导临床正确使用MLSB类抗菌药物。
OBJECTIVE To investigate the resistance of Staphylococcus aureus isolated from our hospital to macrolide（erythromycin） -lincosamide（clindamycin） -streptograminB （MLSB） antibiotics, detect the percentage of inducible clindamycin resistance and the genes for resistant strains. METHODS Disc diffusion method was used to test the resistance of S. aureus to erythromycin and clindamycin. The inducible clindamycin resistance was checked by D-test and the resistant genes for resistant strains were detected by PCR. RESULTS Rates of resistance to erythromycin and clindamycin were 80. 3% and 70. 2%, respectively, in S. aureus isolated from our hospital, and the co-resistance to the two antibiotics （constitutive MLSB resistance） was 70. 2%. Inducible clindamycin resistant （D-test positive） strains accounted for 9.5% among detected strains and 95.5% among erythromycin-re- sistant, clindamycin-susceptible strains, ermA, ermC And msrA were detected in all erythromycin resistant strains. CONCLUSIONS The resistance to MLSB antibiotics is severe in S. aureus isolated from our hospital; the rate of inducible clindamycin resistance is also high among erythromycin-resistant, clindamycin-susceptible strains, and D-test must be done among these strains in clinical laboratory, in order to direct physicians to use MLSB antimicrobial agents correctly.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2007年第2期207-209,156,共4页
Chinese Journal of Nosocomiology
基金
浙江省教育厅基金项目(20051146)
温州医学院科研发展基金项目(2003X21)
