儿科住院患者标本中分离葡萄球菌对红霉素和克林霉素的耐药性

目的了解儿科住院患者标本中分离出的葡萄球菌对红霉素及克林霉素的耐药性,检测红霉素诱导克林霉素耐药的发生情况。方法使用纸片扩散法测定葡萄球菌对红霉素和克林霉素的耐药性,使用D-试验方法检测红霉素诱导克林霉素耐药表型。结果585株葡萄球菌中,金黄色葡萄球菌(SA)406株,其中甲氧西林敏感的SA(MSSA)387株,甲氧西林耐药的SA(MRSA)19株;凝固酶阴性的葡萄球菌(CNS)179株,其中甲氧西林敏感的CNS(MSCNS)20株,甲氧西林耐药的CNS(MRCNS)159株。红霉素、克林霉素均敏感的葡萄球菌117株(20.0%),红霉素和克林霉素均耐药的葡萄球菌282株(48.2%);红霉素耐药、克林霉素敏感的葡萄球菌186株(31.8%),其中D-试验阳性占82.3%(153/186)。MSSA,MRSA,MSCNS和MRCNS中表现为诱导克林霉素耐药分别为92.2%(94/102),50.0%(1/2),77.8%(7/9)和69.9%(51/73)。结论在儿科住院患者标本分离的对红霉素耐药、克林霉素敏感的葡萄球菌中,对克林霉素诱导耐药率高,对该类菌株应采用D-试验检测,以指导临床合理使用抗生素。

Resistance of staphylococci to erythromycin and clindamycin in pediatric patients

ObjectiveTo investigate the resistance of staphylococci to erythromycin and clindamycin in pediatric patients,and to detect the frequency of inducible clindamycin resistance.MethodsDisc diffusion method was used to test the resistance of staphylococcus to erythromycin and clindamycin.The inducible clindamycin resistance was checked by D-test.ResultsIn 585 staphylococcus,there were 406 staphylococcus aureus(SA),which including 387 methicillin sensitive staphylococcus aureus(MSSA) and 19 methicillin resistant staphylococcus aureus(MRSA).And there were 179 coagulase negative staphylococcus,including 20 methicillin sensitive coagulase negative staphylococcus(MSCNS) and 159 methicillin resistant coagulase negative staphylococcus(MRCNS).There were 117strains(20.0%) were sensitive to erythromycin and clindamycin,282 strains(48.2%) were resistant to erythromycin and clindamycin,and 186 strains(31.8%) were sensitive to erythromycin but resistant to clindamycin.Positive strains of D-test accounted for 82.3%(153/186) among erythromycin resistant,clindamycin-susceptible strains.Inducible clindamycin resistant(D-test positive) strains of MSSA,MRSA,MSCNS and MRCNS were 92.2%(94/102),50.0%(1/2),77.8%(7/9)and 69.9%(51/73)respectively.ConclusionThe rate of inducible clindamycin resistance is high among erythromycin-resistant,clindamycin-susceptible strains in pediatric patientd,and D-test must be done among these strains in clinical laboratory in order to guide physicians to use antibiotics correctly.