可诱导克林霉素耐药金黄色葡萄球菌医院感染分子流行病学调查

目的 了解我院金黄色葡萄球菌对红霉素及克林霉素的耐药性，测定红霉素对克林霉素诱导耐药率及诱导耐药基因。方法 双纸片法测定临床分离株红霉素对克林霉素的诱导耐药表型，聚合酶链反应检测诱导耐药基因。结果 94株金黄色葡萄球菌中有77株为红霉素耐药，其中结构型克林霉素耐药45株，诱导型耐药（D试验阳性）26株。51株MRSA中结构型耐药菌株占62．7％，D试验阳性菌株占19．6％。43株MSSA中结构型耐药菌株占30．2％，D试验阳性菌株占37．2％。克林霉素诱导型耐药主要由ermC基因决定。结论临床微生物实验室须加强可诱导克林霉素耐药的检测，以指导临床合理使用大环内酯类、林可酰胺类和链阳霉素B类抗生素。

A molecular epidemiologic investigation of inducible clindamycin resistant Staphylococcus aureus in nosocomial infection

Objective To investigate the resistance of Staphylococcus aureus from daping hospital to erythromycin and clindamycin and detect the percentage and gene for inducible resistance.Methods Inducible clindamycin resistance was detected by double disk diffusion method and the resistant gene was detected by polymerase chain reaction.Results For 94 strain staphylococcus aureus,77 showed erythromycin resistance.Of 77 erythromycin-resistant S.aureus isolates,45 demonstrated constitutive resistance to clindamycin,while 26 showed inducible resistance.For 51 strain MRSA,62.7% showed constitutive clindamycin resistance,while 19.6% showed inducible clindamycin resistance(D-test positive).For 43 strain MSSA,30.2% showed constitutive clindamycin resistance,while 37.2% showed inducible clindamycin resistance(D-test positive).The predominant gene for inducible clindamycin resistance was ermC.Conclusions The inducible clindamycin resistance must be detected in clinical microbiology laboratory for reasonable usage of MLS_B antimicrobial agents.