D试验检测葡萄球菌属中克林霉素诱导型耐药

D-test for Detection of Inducible Resistance to Clindamycin in Staphylococci

目的应用D试验检测葡萄球菌属中红霉素对克林霉素的诱导耐药性,了解葡萄球菌属对红霉素及克林霉素的耐药率。方法按照美国临床实验室标准化委员会2004年推荐的标准,测定葡萄球菌属中红霉素对克林霉素的诱导耐药表型。结果77株葡萄球菌属(金黄色葡萄球菌20株,凝固酶阴性葡萄球菌57株)中,红霉素与克林霉素同时耐药者分别占50.0%和22.8%,红霉素耐药而克林霉素敏感分别占20.0%和59.6%,其中D试验阳性分别占红霉素耐药而克林霉素敏感菌株的50.0%和61.8%。结论临床微生物室应开展D试验检测葡萄球菌属中克林霉素诱导型耐药,以指导临床医生合理选用大环内酯类、林可霉素类、B类链阳霉素类抗菌药物。

OBJECTIVE To apply D-test for detection of inducible resistance of erythromycin to clindamycin in staphylococci and investigate their resistant rate to erythromycin and clindamycin. METHODS According to the standards of NCCLS to detect inducible resistance of erythromycin to clindamycin in staphylococci. RESULTS Coresistance to erythromycin and clindamycin accounted for 50% and 22.8% in 77 strains of staphylococci （20 of S. aureus and 57 of coagulase-negative staphylococci）. The rate of erythromycin resistance and clindamycin sensitivity accounted for 20% and 59.6%. D-test positive rate was 50% and 61.8% of which were erythromycin resistant and clindamycin sensitive respectively. CONCLUSIONS D-test for detection of inducible resistance of erythromycin to clindamycin in staphylococci should be checked in clinical microbiology laboratory in order to help physicians to select MLSb antimicrobial agents correctly.