克林霉素诱导实验在金黄色葡萄球菌药物敏感实验中的应用

Survey of Inducible Clindamycin Resistant in Staphylococcus aureus

目的通过对金黄色葡萄球菌诱导克林霉素耐药的研究,为临床使用红霉素和克林霉素提供可靠的实验依据。方法应用MicroScan WalkAway-96SI微生物鉴定系统鉴定MRSA和MSSA和药敏试验。根据NCCLS 2004年版"增加对检测诱导克林霉素耐药的注释"对红霉素耐药,克林霉素敏感菌进行D-试验。结果242例金黄色葡萄球菌,MRSA占42%(101/242),MSSA占58%(141/242),红霉素和克林霉素耐药率分别为78.5%(191/242)、60.7%(147/242),二者同时耐药(结构型MLSB耐药)的菌株占60.7%(147/242),242株金黄色葡萄球菌D-试验阳性占所检测菌株的14.9%(36/242);43株红霉素耐药而克林霉素敏感金黄色葡萄球菌D-实验结果:阳性率为83.7%(36/43)。结论临床应常规检测金黄色葡萄球菌诱导型克林霉素耐药,避免盲目使用克林霉素而导致治疗失败。

Objective To research Staphylococcus aureus inducible clindamycin resistant, so as to provide more reliable evidence for the clinical rational use of antibiotics guide treatment. Method MicroScan WalkAway- 96SI Microbial Identification System were used for identification and sensitivity of MRSA and MSSA. According to the notes of NCCLS 2004 edition, ＂to increase the detection of induced resistance of clindamycin＂, erythromycin resistance but clindamyein sensitive bacteria were done D-test. Results Of 242 strains Staphylococcus aureus, MRSA accounted for 42% （ 101/242 ）, MSSA accounted for 58% （ 142/242）, erythromycin and elindarnycin resistance rates were 78.5% （191/242） and 60. 7% （ 147/242）, while the resistance to the both drugs （MLS-resistant structure ） accounted for 60. 7% （147/242）. Inducible elindamycin resistance （D-test positive） strain accounted for 14.9% （36/242）. And in 43 strains which were resistant to erythromycin and sensitive to elindmycin, 36 strains were D-test positive, and the positive rate was 83.7%. Conclusion The clinical testing of Staphylococcus aureus should conduct routinly inducible elindamycin resistance test to avoid irrational use of antibiotics.