甲氧西林耐药与敏感金黄色葡萄球菌克林霉素诱导耐药的分析  

Drug resistance to clindamycin induced by meticillin-resistant and susceptible staphylococcus aureus

作　　者：王群 吕火祥[2] 杨央 胡庆丰[2] 沈蓓琼[2] 徐娟[2] 朱永泽[2] 

机构地区：[1]浙江省淳安县中医院检验科,浙江淳安县311700 [2]浙江省人民医院检验医学中心,浙江杭州310014 [3]浙江省宁海县妇幼保健院检验科,浙江宁海县315600

出　　处：《中华医院感染学杂志》2011年第5期855-857,共3页Chinese Journal of Nosocomiology

摘　　要：目的了解耐甲氧西林金黄色葡萄球菌(MRSA)和甲氧西林敏感金黄色葡萄球菌(MSSA)的耐药性及克林霉素诱导型耐药发生率,为临床治疗提供依据。方法 427株金黄色葡萄球菌用双纸片扩散法检测诱导型克林霉素耐药率;对其中的279株MRSA以E-试验检测万古霉素的MIC;对红霉素耐药而克林霉素敏感的菌株进行D-试验。结果 427株金黄色葡萄球菌中,红霉素耐药而克林霉素敏感的114株,其中MRSA 68株,D-试验阳性59株,阳性率86.8%;MSSA为46株,D-试验阳性39株,阳性率84.8%;279株MRSA对万古霉素的MIC值分布为0.75 mg/L 27株1、.0 mg/L 75株1、.5 mg/L 98株2、.0 mg/L 64株、2.5 mg/L 15株。结论万古霉素对耐甲氧西林金黄色葡萄球菌有良好的抑菌效果;MRSA表现为多药耐药性,检测克林霉素诱导型耐药具有重要的临床应用价值。OBJECTIVE To investigate the antimicrobial resistance and the prevalence of inducible clindamycin resistance of meticillin-resistant Staphylococcus aureus （MRSA） and meticillin-susceptible Staphylococcus aureus （MSSA）. METHODS The antimicrobial susceptibility test of 279 MRSA strains to vancomycin was performed by E-test method, The antimicrobial susceptibility of erythromycin and clindamycin for 427 strains of S. aureus were by disk diffusion method. For these isolates of The erythromycin-resistant but clindamycin-susceptible were checked by D-test according to the standards of CLSI. RESULTS Of the 427 strains of S. aureus, the erythromycin-resistant but clindamycin-susceptible isolates were 114 strains. Among them,68 strains of MRSA, the D-test positive was 59 （86.8%）. And,39 strains （46） of MSSA, the D-test positive was 39 （84.8%）. The distribution of minimal inhibitory concentration of 279 strains of MRSA were as followings： 27 strains to be 0.75mg/L;75 strains to be 1.0mg/L, 98 strains to be 1.5mg/L, 64 strains to be 2.0mg/L and 15 strains to be 2.5mg/L. CONCLUSION Vancomycin has a good antibacterial effect to MRSA. The MRSA shows multi-drug resistance, the D-test is valuable in clinics.

关 键 词：耐甲氧西林金黄色葡萄球菌 耐药性 克林霉素 诱导型耐药 最低抑菌浓度 

分 类 号：R978.1[医药卫生—药品]