凝固酶阴性葡萄球菌诱导型克林霉素耐药的检测与分析

目的了解本地区凝固酶阴性葡萄球菌（CNS）对红霉素及克林霉素的耐药性和克林霉素诱导型耐药的发生率，分析红霉素耐药CNS对大环内酯类抗菌药物的耐药机制。方法用双纸片扩散法检测280株CNS对红霉素和克林霉素的耐药性，用D试验检测红霉素对克林霉素的诱导耐药率。结果280株CNS中，红霉素敏感且克林霉素敏感株占15．7％，红霉素耐药且克林霉素耐药株占37．5％，红霉素耐药且克林霉素敏感株占46．8％；红霉素耐药且克林霉素敏感的CNS中，诱导型克林霉素耐药的检出率为57．3％，其中甲氧西林耐药CNS（MRCNS）和甲氧西林敏感CNS（MSCNS）中的检出率分别为56．8％和66．7％，两者差异无统计学意义。结论临床微生物实验室应加强CNS中诱导型克林霉素耐药的检测，以指导临床合理使用抗菌药物。

Detecion and analysis for induction of clindamycin resistance in coagulase-negative Staphylococcus

Objective To investigate the resistance of coagulase-negative Staphylococcus （CNS） to erythromycin and clindamycin and the percentage for inducible resistance in order to analyse CNS resistance mechanism to macrolides antibotics in our region. Methods The susceptibilities of erythromycin and clindamycin for 280 CNS strains were determined by double disk diffusion test and the inducible resistance of erythromycin to clindamycin was detected by D test. Results The rates of co-resistance and co-sensitivity to erythromycin and clindamycin accounted for 15. 7% and 37.5% in CNS isolated from our hospital, respectively. And other isolates of CNS resistant to erythromycin but susceptible to clindamycin accounted for 46.8%. In addition, the rates of inducible resistance to clindamycin were 57.3% , 56.8% and 66.7% in total CNS, methicillin-resistant CNS （MRCNS） and methicillin-susceptible CNS （MSCNS） which possessed erytbromycin-resistant and clindamycin-susceptible by individual disk diffusion test, respectively. Conclusions The detection of inducible clindamycin resistance must be stressed in clinical microbiology laboratory in order to guide physicians to select reasonable antibiotics for CNS infection.