摘要
目的:了解葡萄球菌对红霉素及克林霉素的耐药性,结合药敏试验结果,为临床合理选择抗生素提供可靠依据。方法:按照2004年版美国临床实验室标准化委员会(NCCLs)推荐的纸片扩散方法,测定并判读葡萄球菌对红霉素和克林霉素的耐药性,并以D-试验测定红霉素对克林霉素的诱导耐药表型。结果:红霉素和克林霉素同时耐药在耐甲氧西林葡萄球菌(MRSA)和甲氧西林敏感型葡萄球菌(MSSA)中分别占45.50%(192/422)和55.14%(193/350);对红霉素耐药而克林霉素敏感的MRSA和MSSA中,D-试验阳性(即对克林霉素具有诱导耐药性者)分别为69.72%和30.58%。D-试验阳性占所测葡萄球菌的24.48%,占对红霉素耐药而克林霉素敏感菌株的30.58%。结论:红霉素诱导克林霉素发生耐药应引起关注,开展药敏试验及D-试验,检测葡萄球菌中红霉素对克林霉素诱导性耐药,可指导临床医师合理选用大环内酯类、克林霉素类抗菌药物。
Objective： To study the drug resistance of erythromycin and clindamycin caused by Staphylococcus aureus, in combination with sensitivity test results, and to provide reference for clinical rational antibiotics use. Methods： Reference to the U.S. Committee for Clinical Laboratory Standards （NCCLS） recommended paper diffusion method. Surveying and evaluating the drug resistance of erythromycin and clindamycin caused by Staphylococcus aureus, and using D-test to fmd out the clindamycin resistance phenotype induced by erythromycin. Results： Erythromycin and clindamycin both had drug resistance： 51.65% of erythromycin got resistent to methicillin resistant Staphylococcus aureus, and 34.57% of clindamycin got resistent to methicillin sensitive Staphylococcus aureus. Two bacterial strains which got resistent to erythromycin and sensitive to clindamycin, have the positive result of D-test（ induced resistance to clindamycin）69.72% and 30.58%, separately. The total percentage of the Staphylococcus that got D-test positive occupied the part of 24.48%, meanwhile, the D-test positive bacterial strain that got resistent to erythromycin and sensitive to clindamycin occupied the part of 30.58%. Conclusion： We should pay more attention to the clindamycin drug resistance induced by erythromycin. The development of antibiotic sensitivity tests, D-test, and the detection of Staphylococcus resistance in clindamycin-induced, guide the clinical reasonable usage of macrolides antibiotics and clindamycin.
出处
《抗感染药学》
2010年第1期44-46,共3页
Anti-infection Pharmacy
