D-试验对葡萄球菌红霉素诱导克林霉素耐药情况调查

Investigation of clindamycin-induced resistance by erythromcin in Staphylococcus by D-test

目的:了解本院临床分离的葡萄球菌对红霉素和克林霉素诱导型耐药的发生率,帮助临床医生合理选用抗生素。方法:用K-B法检测葡萄球菌属对红霉素及克林霉素的耐药性,按照CLSI/NCCLS 2004年推荐的D-试验方法检测克林霉素诱导型耐药。结果:232株受试葡萄球菌,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分别占44.78%和13.94%。D-试验阳性占所检测葡萄球菌的18.53%,占红霉素耐药而克林霉素敏感菌株的52.43%。红霉素耐药而克林霉素敏感的金黄色葡萄球菌和凝固酶阴性葡萄球菌中,D-试验阳性即对克林霉素具诱导耐药性者分别为65.38%和46.42%。结论:我院分离的葡萄球菌多重耐药发生率较高,微生物实验室开展的D-试验可检测红霉素对克林霉素的诱导耐药,临床医生应高度关注。

Objective ：To investigate the incidence of clindamycin - induced resistance in clinical strains of Staphylococcus and help clinical physicians select appropriate drugs. Methods：To detect the erythromcin and clindamycin resistance of Staphylococcus by K - B agar diffusion method and the clindamycin - induced resistance by D - test which is recommended by CLSI/ NCCLS. Results：44. 78% of MRSA and 13. 94% of MRCNS in 232 stains Staphylococcus are resistant to erythromcin and clindamycin. 18.53% of detected Staphylococcus are positive by D - test, and 52.43% of erythromcin resistant Staphylococcus are positiw In Staphylococcus aureus which are resistant to erythromcin and sensitive to clindamycin and Staphylococcus whose coagulase is negtive, the positive rate of D - test are 65.38% and 46.42% respectively. Conclusion：The rate of clindamycin - induced resistance is high in our hospital and physicians should keep an eye on it.