金黄色葡萄球菌红霉素诱导克林霉素耐药的情况分析  

Analysis on inducible resistance of Staphylococcus aureus to clindamycin

作　　者：徐伟红[1] 徐斌[2] 

机构地区：[1]上海市长宁区同仁医院检验科,200050 [2]复旦大学生命科学院

出　　处：《检验医学与临床》2013年第A01期71-73,共3页Laboratory Medicine and Clinic

摘　　要：目的了解临床分离金黄色葡萄球菌的耐药性及诱导型克林霉素耐药的发生率，评价微量肉汤稀释法检测诱导型克林霉素耐药的临床应用价值。方法VITEK-2微生物分析系统对临床分离菌株进行鉴定和药物敏感性测定；红霉素和克林霉素双纸片扩散法和微量肉汤稀释法检测诱导型克林霉素耐药，并比较检测。结果122株金黄色葡萄球菌中耐甲氧西林金黄色葡萄球菌（MRSA）占59．0％。金黄色葡萄球菌对红霉素及克林霉素同时耐药的有71株，占58．2％，对红霉素耐药而对克林霉素敏感或中介的有28株，其中D试验阳性21株，红霉素诱导克林霉素耐药率76．5％。红霉素耐药而克林霉素敏感或中介的MRSA和甲氧西林敏感金黄色葡萄球茵（MSSA）中D试验阳性分别为81．3％和61．7％。所有K—B法、D试验阳性菌株微量肉汤稀释法也均为阳性，两者符合率为100％。结论克林霉素诱导型耐药发生率高，临床微牛物实验室对红霉素耐药、克林霉素敏感的葡萄球菌应常规进行D试验，报道克林霉素诱导型结果；为临床医生正确用药提供依据。Objective To investigate the drug resistance and prevalence of inducible clindamycin resistance in clinical isolates of Staphylococcus aureus （SA） and to evaluate the application value of microdilution method for the detection of inducible clindamycin resistance in SA. Methods Bacteria identification and susceptibility testing were performed by using VITEK-2 system and Kirby-Bauer disk method. The inducible clindamycin resistance was deter- mined by D test with the combination of erythromycin and clindamycin and microdilution technique. Results In 122 strains of SA,methicillin resistant SA （MRSA） accounted for 59.0%. 71 SA strains were resistant to both erythro- mycin and clindamycin,accounting for 58.2 %. 28 strains were erythromycin resistant and clindamycin susceptible or intermediate,including 21 positive strains in D test,and the percentage of erythromyein induced resistance to clinda- mycin was 76.5%. The positive rates of D test were 81.3% and 61.7% in erythremycin resistant and clindamyein susceptible or intermediate MRSA and methicillin sensitive SA （MSSA）. The broth microdilution method performed identically with D test. Conclusion The detection of inducible clindamycin resistance in SA should be paid attention in clinical microbiology laboratories in order to guide physicians to select antimicrobial agents correctly such as macrolides and lincosamides.

关 键 词：金黄色葡萄球菌 红霉素 克林霉素 耐药 

分 类 号：R378.11[医药卫生—病原生物学]