实验室葡萄球菌检测中克林霉素诱导耐药性的分析和对策

目的了解葡萄球菌对红霉素和克林霉素的耐药性及其以红霉素诱导克林霉素耐药的发生率。方法用K—B法检测葡萄球菌对红霉素及克林霉素的耐药性，依据NCCLS2004年发布M100-S14的D-试验方法，测定红霉素对克林霉素的诱导耐药表型。结果耐甲氧西林金黄色葡萄球菌（MRSA）和耐甲氧西林凝固酶阴性葡萄球菌（MRCNS）对红霉素及克林霉素同时耐药者分别占91．66％和68．42％。其中D-试验阳性的金黄色葡萄球菌和凝固酶阴性葡萄球菌分别占70．00％（7／10）和58．10％（32／55），有60．00％的对红霉素耐药和克林霉素敏感的葡萄球菌为诱导型克林霉素耐药菌。结论各级临床微生物室应开展D-试验，检测葡萄球菌中红霉素对克林霉素的诱导耐药性，指导临床医生更合理地使用抗生素。

Analysis and countermeasures of the inducible clindamycin resistance in Staphylococcus detection

Objective To investigate the resistance of Staphylococcus to erythromycin and clin-damycin, and anzlyze prevalence of erythromycin inducible clindamyein resistance. Methods The drug resistance of Staphylococcus to erythromycin and clindamycin was determined by Kirby-Bauer disc agar diffusion test and the inducible resistance phenotype of erythromycin to clindamyein was determined by D-test according to the standards of NCCLS (2004 M100-S14). Results In tested SA and CNS, co-re-sistant Staphylococcus to erythromyein and clindamyein accounted for 91.68% and 68. 42% respec-tively. D-test positive rate was 70. 00% (7/10) in MRSA and 58.10% (32/55) in MRCNS. The rate of erythromyein resistance and clindamycin sensitivity was 60. 00% and all of the Staphylococcus iso-lates were inucible clindamycin-resistant. Conclusion D-test should be carried out to detect the eryth-romyein inducible resistance to clindamycin to guide more rational clinical treament of Staphylococcus infection.