摘要
目的了解本地区临床感染葡萄球菌对大环内酯类药物和克林霉素不同耐药表型及诱导型克林霉素耐药的发生率。方法采用K-B琼脂扩散法检测葡萄球菌对红霉素和克林霉素的耐药性,头孢西丁纸片扩散法检测耐甲氧西林葡萄球菌,D-试验检测克林霉素诱导型耐药表型。结果所有308株葡萄球菌中,162株对红霉素和克林霉素均耐药,即为结构型耐药,占葡萄球菌的44.16%;109株对红霉素耐药、克林霉素敏感、但D-试验阳性,即为诱导型耐药,占葡萄球菌27.92%;49株对红霉素耐药、克林霉素敏感、但D-试验阴性,即MS型。诱导型克林霉素耐药表型在MRSA、MSSA、MRCNS、MSCNS中分别占24.41%、10.46%、41.86%、23.26%。结论对大环内酯类药物耐药的金黄色葡萄球菌和凝固酶阴性葡萄球菌分离株对克林霉素敏感的菌株出现诱导型耐药,对于这些菌株应加做D-试验,以免盲目将药敏结果报告给临床,造成临床治疗失败。
Objective To investigate the resistant phenotype of erythromycin and cindamycin against staphylococcus and the prevalence of inducible clindamyein resistant in erythromycin resistant staphylococcus in local district. Methods Using KB method were Performd to detected the resistant against staphylococcus , cefoxitin disk diffusion method and D-test suggested by NCCLS 2004 guidelines were used to detect methicillin-resistant staphylococcus and the inducible clindamyein resistant staphylococcus. Re- suits Of all 308 staphylococcus strains 136 were botherythrmycin and clindamyein resistance to staphylococcus,the percentaye of staphylococcus was 44.16 % ,86 were erresistant to erythromyein but susceptible to clindamyein and showed positive D-test results （Imls）, the percentntaye of staphylococcus was 27. 92~, 49 were resistant to erythromyein but susceptible to clindamyein and showed positive D-test results（MS）,Among the phenotype of resistant to erythromyein but susceptible to clindamyein the rates of inducible clindamyein-resistant of MRSA, MSSA, MRCNS, MSCNS were 75.00%, 64. 29%, 77. 50%, 59.26%. Conclusion The results indicated that D-test should Be performed in dindamycin susceptible isolates which were failing in clinical therapy by using clindamycin for staphylococcal infection,The detection of inducible clindarnycin resistant must be stressed in clinical microbiology laboratory to provide goog support for rational antibiotic therapy.
出处
《国际检验医学杂志》
CAS
2011年第2期208-209,共2页
International Journal of Laboratory Medicine
关键词
葡萄球菌属
克林霉素
红霉素
抗药性
细菌
staphylococcus
clindamycin
erythromycin
drug resistance, bacterial
