摘要
目的了解临床分离金黄色葡萄球菌的耐药性及克林霉素诱导型耐药的发生率,评价头孢西丁和苯唑西林纸片扩散法检测MRSA的临床应用价值。方法VITEK-2微生物分析系统及K-B法药敏试验对临床分离菌株进行鉴定和药物敏感性测定;胶乳凝集试验检测PBP2a;头孢西丁和苯唑西林纸片扩散法检测MRSA;双纸片扩散法检测诱导型克林霉素耐药;WHONET 5.4及SPSS11.3软件对结果进行统计分析。结果青霉素和氨苄西林耐药率最高,分别为98.9%和100.0%,未发现万古霉素耐药或中介菌株;93株金黄色葡萄球菌中,MRSA和MSSA分别为58株(62.4%)和35株(37.6%),MRSA对11种抗菌药物的耐药率高于MSSA;头孢西丁纸片扩散法的敏感性和特异性分别为98.3%和97.1%,苯唑西林纸片扩散法的敏感性和特异性分别为75.9%和94.3%;对红霉素耐药而克林霉素敏感的9株金黄色葡萄球菌中,5株(55.6%)为诱导型克林霉素耐药。结论临床分离金黄色葡萄球菌耐药性已十分严重;头孢西丁纸片扩散法是检测MRSA简便、可靠的方法;临床微生物室应常规检测金黄色葡萄球菌红霉素对克林霉素的诱导耐药性。
OBJECTIVE To investigate the drug resistance and the prevalence of inducible clindamycin resistance in clinical isolates of Staphylococcus aureus and evaluate the clinical value of cefoxitin disk diffusion method and oxacillin disk diffusion for detection of meticillin-resistant S. aureus （MRSA）. METHODS Bacteria identification and susceptibility test were performed by VITEK-2 system and K-B disk method. The PBP2a was detected by latex agglutination and MRSA was identified by cefoxitin disk diffusion method and oxacillin disk diffusion. The inducible resistance of erythromycin to clindamycin was checked by D-test according to the standards of CLSI （NCCLS）. The statistical analysis was performed by WHONET 5. 4 and SPSS 13. 0 software. RESULTS Resistant rate to penicillin and ampicillin was 98.9% and 100.0%, respectively. Vancomycin-resistant （VRE） or intermediate strains were not found. Of the 93 S. aureus isolates, MRSA and meticillin-sensitive S. aureus （MSSA） were 58 （62.4%） and 35 （37. 6%）, respectively. The resistant rate of MRSA to 11 antibiotics was higher than MSSA. The sensitivity and specificity of cefoxitin disk diffusion method were 98. 3% and 97. 1%, respectively, those of oxacillin disk diffusion were 75.9% and 94.3%. Of the 9 isolates resitant to erythromycin but susceptible to clindamycin, 5 （55.6 %） showed inducible resistance to clindamycin. CONCLUSIONS Resistance of S. aureus is quite serious. Cefoxitin disc diffusion method is a simple and reliable method for the detection of MRSA. The inducible resistance of erythromycin to clindamycin in S aureus should be checked by D-test in clinical microbiology laboratory routinely.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2009年第5期574-577,共4页
Chinese Journal of Nosocomiology
