摘要
目的了解医院内感染可诱导克林霉素耐药葡萄球菌的发生率及常用抗菌药物对葡萄球菌的体外抗菌活性和联合药敏实验。方法细菌鉴定应用VITEK全自动细菌鉴定分析系统;药敏试验采用KB纸片法和琼脂平板稀释法,按CLSI规定的标准进行;用D-试验检测可诱导克林霉素耐药的发生率。结果2005年7月至2006年4月从临床各种感染标本中分离得到113株葡萄球菌,其中iMLSB表型(D-试验阳性)占34.5%;MSB表型(红霉素R,克林霉素S)占16.8%;cMLSB表型(红霉素R,克林霉素R)占41.6%;红霉素耐药克林霉素敏感表型葡萄球菌58株中D试验阳性率为67.2%;D-试验阳性葡萄球菌对万古霉素、左氧氟沙星、阿米卡星、头孢唑林的MIC90分别为2.0、8.0、4.0、16(mg/L),万古霉素与左氧氟沙星、阿米卡星、头孢唑林联合药敏结果MIC90均为1.0(mg/L)。结论医院内感染诱导型克林霉素葡萄球菌的发生率已越来越高,临床应根据细菌实验室的耐药表型检测合理应用抗菌药物。
Objective To investigate the incidence of inducible clindamycin-resistant staphylococcus in nosocomial infection, and analyze in vitro activity of the routine antibiotics （alone or in combination） against staphylococcus. Methods Use automatic system VITEK to identify and analyze the bacteria; Kirby-Baucer method and agar dilution method to detect drug susceptibility following CLSI standards; and D-Test to detect the incidence of inducible clindamycin-resistant staphylococcus. Results In the 113 strains of staphylococcus isolated from the various clinical samples during July, 2005 and April, 2006, among iMSB （D-Test is posi- tive. ）, MSB （ER-R, CL-S） and cMLSB （ER-R, CL-S） phenotypes were 34.5%, 16.8% and 41.6% respectively. The positive incidence in D-Test was 67. 2% with 58 samples of staphylococcus which was susceptible to clindamycin while resistant to erythromycin. The MICg0 of vancomycin, levofloxacin, amikacin and cefazolin against D-test positive staphylococcus were 2.0, 8.0, 4.0, 16 mg/L respectively. The MICg0 of combined drug sensitivity result of levofloxacin, amikacin, cefazolin were all 1.0 mg/L when combined with vaneomyein. Conclusions The incidence of infection with staphylococcus was growing, which was possible to induce drug resistance to clindamycin in nosocomial infections. The clinical use of antimicrobial agent should follow the instruction of the drug resistance phenotype given by the bacterial laboratory.
出处
《中国抗生素杂志》
CAS
CSCD
北大核心
2008年第7期438-441,共4页
Chinese Journal of Antibiotics
关键词
葡萄球菌
克林霉素
红霉素
抗菌药物
D-试验
联合药敏试验
耐药性
Staphylococcus
Clindamycin
Erythromycin
Antimicrobial agent
D-Test
Corn- bining drug susceptibility test
Drug resistance
