耐红霉素葡萄球菌对克林霉素诱导型耐药的检测

目的了解本院临床分离的葡萄球菌对克林霉素诱导型耐药的发生率,帮助临床医师正确选择药物。方法采用K-B纸片琼脂扩散法检测葡萄球菌对红霉素和克林霉素的耐药性,按照CLSI/NCCLS推荐的D-试验方法检测克林霉素诱导型耐药。结果133株受试葡萄球菌对红霉素和克林霉素耐药菌株数分别为66株(占49.6%)和43株(占33.3%),66株耐红霉素葡萄球菌中有20株(其中金黄色葡萄球菌10株、表皮葡萄球菌9株、腐生葡萄球菌1株)为克林霉素诱导型耐药株,占红霉素耐药株的30.3%。在红霉素耐药金黄色葡萄球菌和凝固酶阴性葡萄球菌中,克林霉素诱导型耐药的检出率分别达38.5%和25.0%。对红霉素和克林霉素同时敏感或克林霉素耐药株中,未检到克林霉素诱导型耐药株。结论对红霉素耐药克林霉素敏感葡萄球菌应进行D试验,报告克林霉素诱导耐药性结果,以便临床正确选择药物。

Detection for inducible clindamycin resistance in erythromycin-resistant isolates of Staphylococcus

Objective To investigate the probability of induction of clindmycin resistance in isolates of Staphylococcus from clinical lab and help clinical physicians to select appropriate therapy decision.Methods K-B disk agar diffusion method was used to test erythromycin or clindamycin resistance in isolates of Staphylococcus,D-test recommended by CLSI/NCCLS was used to examine the inducible resistance of erythromycin to clindamycin.Results The percents of erythromycin-resistant isolates and clindamycin-resistant isolates accounted for 66(49.6%)and 43(33.3%)in 133 tested isolates of Staphylococcus,respectively.And there were 20 inducible clindamycin-resistant isolates(including 10 isolates of S.aureus,9 isolates of S.epidermidis and 1 isolate of S.saprophyticus)whose rate was 30.3% among the 66 erythromycin-resistant isolates.The rates of inducible resistance to clindamycin were 38.5% and 25% in erythromycin-resistant isolates of S.aureus and coagulase-negative Staphylococcus,respectively.There was no induction of clindamycin resistance in isolates with both erythromycin and clindamycin sensitive or clindamycin resistant.Conclusion Erythromycin-resistant and clindamycin-sensitive isolates should be checked by D-test in clinical lab so as to offer physicians correct antimicrobial agents information.