摘要
目的 研究耐甲氧西林葡萄球菌（MRS）对大环内酯类（M）-林可酰胺类（L）-链阳菌素类（S）抗生素（MLS）的耐药机制，以指导临床用药。方法 采用K-B扩散法测定90株MRS临床分离株的MLS六种代表药物（红霉素、阿齐霉素、麦迪霉素、乙酰螺旋霉素，克林霉素和奎奴普丁／达福普丁）的药敏试验，分析其耐药表型，推测其耐药机制。结果 ①MRS对MLS有5种药敏表型，最主要的表型为ML耐药/S敏感（71．11％）；MRSA和MRCNS的药敏表型分布不一样，未见奎奴普丁／达福普丁（QD）耐药。②MRSA有两种靶位改变所致的耐药表型。分别为11．1％和71．1％，另有两种机制不明表型，分别为6．7％和11．1％；未发现外排系统所致耐药表型。③MRCNS也有两种靶位改变所致的耐药表型分别为8．9％和71．1％；存在外排系统所致的耐药表型，为13．3％。结论 MRS均主要为靶位改变所致的耐药，MRSA存在两种不明机制耐药，MRCNS存在外排系统所致的耐药。
Objective To study resistance mechanisms of methicillin-resistant staphylococcus （MRS） to macrolides （M）, lincosamides （L） and streptogramins （S） （MLS）. Method To detect the susceptibility of 90 MRS strains with K-B diffusion test, analyze the resistant rates and phenotypes, speculating upon theirs resistance mechanisms. Results ①There were five resistant phenotypes of MRS to MLS, the main phenotypes was ML resistant/S susceptibility （71.11%）, the phenotypes of MRSA, MRCNS were difference, no phenotype of QD resistant.②There are two kinds of phenotypes caused by target changing in MRSA, 11.1% and 71.1%, respectively, and there are two kinds phenotypes which caused by unclear reason, 6.7% and 11.1%, respectively, and no phenotypes caused by outer-pumps. ③There are two kinds of phenotypes caused by target changing in MRSCN, 8.9% and 71.1%, respectively, and there is a phenotype which caused by outer-pumps, 13.3%. Conclusions The resistant mechanisms of MRS to MLS are caused by target changing, there are two kinds phenotypes which caused by unclear reason in MRSA, and a phenotype which caused by outer-pumps in MRSCN. streptogramins
出处
《世界感染杂志》
2006年第2期140-141,共2页
World Journal of Infection
