58株葡萄球菌对红霉素诱导克林霉素耐药的检测与分析  

Analysis and Determination of Erythromycin Induced Clindamycin Resistance in 58 Strains of Staphylococcus

作　　者：张静[1] 石祥奎 

机构地区：[1]徐州市妇幼保健院,江苏徐州221009

出　　处：《抗感染药学》2016年第1期48-50,共3页Anti-infection Pharmacy

基　　金：徐州市临床药学课题(编号:XZZDY1309)

摘　　要：目的:检测与分析儿科葡萄球菌肺炎患者中葡萄球菌对红霉素诱导克林霉素耐药情况,为临床合理用药提供参考。方法:采用美国临床实验室标准化委员会(NCCLS)(2004版)推荐的K-B琼脂扩散法,检测葡萄球菌对红霉素、克林霉素以及β-内酰胺类药物的耐药情况;采用头孢西丁纸片扩散法检测耐甲氧西林葡萄球菌(MRSA);采用D-试验法检测克林霉素诱导型耐药表型。结果:药敏结果示58株葡萄球菌中,MRSA为32株,甲氧西林敏感金葡菌(MSSA)为26株;32株MRSA中耐头孢唑啉26株(耐药率为81.25%),耐头孢呋辛26株(耐药率为81.25%),耐美洛西林14株(耐药率为43.75%);26株MSSA中耐青霉素21株(耐药率为80.77%),耐头孢西丁1 4株(耐药率为53.85%),耐头孢唑啉5株(耐药率为19.23%),耐头孢呋辛5株(耐药率为19.23%),以及耐美洛西林6株(耐药率为23.08%);32株MRSA中,对红霉素和克林霉素均敏感的2株;对红霉素和克林霉素均耐药的16株,红霉素耐药而克林霉素敏感的14株(这14株中D-试验示阳性的9株,即诱导耐药的发生率为64.28%);26株MSSA中,对红霉素和克林霉素均敏感的6株,对红霉素和克林霉素均耐药的9株,红霉素耐药而克林霉素敏感的11株葡萄菌(在这11株中,克林霉素被诱导耐药的6株,发生率为54.54%);58株葡萄球菌中,其中15株D-试验显示阳性,占25.86%(15/58)。结论:开展D-试验检出医院儿科患者红霉素诱导克林霉素耐药,为儿科临床合理使用抗菌药物提供参考。Objective： To analyze and determine the erythromycin induced clindamycin resistance in pediatric Staphylococcus pneumonia patients and to provide a reference for clinical rational drug use. Methods：National Committee for Clinical Laboratory Standards（NCCLS） （2004 edition） recommended K-B agar diffusion, the drug resistance of Staphylococcus to erythromycin, clindamycin and β-lactams was determined. The methicillin-resistant Staphylococcus aureus （MRSA） was tested by cefoxitin disc diffusion method. The phenotype of clindamycin induced resistant was detected by the D-test method. Results： 32 strains of MRSA and 26 strains of MSSA in 58 strains of Staphylococcus were shown by drug susceptibility results. The resistants to cefazolin were 26 strains and the resistant rate was 81.25%; Cefuroxime was 26 strains, resistant rate was 81.25% and mezlocillin was 14 strains and resistant rate was 43.75% in 32 strains of MRSA. In 26 strains of MSSA, the resistants to penicillin resistant rate was 80.77% and cefoxitin 14 strains resistant, resistant rate was 53.85%; Cefazolin 5 strains of resistant rate was 19.23%; Cefuroxime 5 strains resistant, resistant rate was 19.23%; Mezlocillin 6 strains resistant and resistant rate of 23.08%. MRSA in 58 strains of staphylococcus to erythromycin and clindamycin sensitive 2 strains of staphylococcus aureus, D-test negative two strains; Sensitive to erythromycin and clindamycin resistance of 14 strains of staphylococcus aureus, D-test positive for 9 strains, which induce drug resistance rate of 64.28%. MSSA erythromycin and clindamycin resistance in the sensitive grapes 11 strains of bacteria and the induced resistance of 6 cases, the incidence was 54.54% and D-test positive staphylococcus accounted for 25.86% （15/58）. Conclusion： Erythromycin induced clindamycin resistance was checked out by D-test in hospital pediatric patients and to provide a reference for clinical rational drug use.

关 键 词：D-试验 儿科 葡萄球菌肺炎 红霉素 克林霉素 

分 类 号：R969.3[医药卫生—药理学]