葡萄球菌属中红霉素诱导克林霉素耐药的检测

Detection for inducible clindamycin resistance in erythromycin-resistance isolates of Staphylococcus

目的了解我院临床分离的葡萄球菌红霉素对克林霉素诱导耐药的发生率,为临床医生正确选择药物提供依据。方法采用K-B纸片方法检测葡萄球菌红霉素和克林霉素的耐药性。按照CLSI/NCCLS推荐的D-试验方法检测克林霉素诱导型耐药情况。结果 152株葡萄球菌中有68株(金黄色葡萄球菌31株,凝固酶阴性葡萄球菌37株)呈红霉素耐药、克林霉素敏感,其中31株D-试验阳性(金黄色葡萄球菌14株,凝固酶阴性葡萄球菌17株),检出率分别为45.2%、45.9%,其他药敏表型未检出D-试验阳性菌株。结论克林霉素诱导型耐药发生率高,临床微生物实验室对红霉素耐药、克林霉素敏感的葡萄球菌应常规进行D-试验,报道克林霉素诱导型结果,为临床医生正确用药提供依据。

Objective To investigate the probability of induction of clindamycin resistance in isolates of Staphylococcus from clinical laboratory and give the proofs of using antibiotic for clinical physicians. Methods K-B disk diffusion method was used to test erythromycin resistance and clindamycin resistance in isolates of Staphylococcus. D-test recommended by CLSI/NCCLS was used to examine the inducible resistance of erythromycin to clindamycin. Results A total of 68 strains （31 strains of Staphylococcus aureus, 37 trains of coagulate-negative Staphylococcus） were erythromycin-resistant but clindamycin-senstive in the 152 trains of Staphylococcus, 31 trains were positive in D-test （14 strains of Staphylococcus aureus, 17 trains of coagulate-negative Staphylococcus）, the positive rates were 45.2% and 45.9%. None of the Staphylococcus was positive in D-test in other types of drug resistance. Conclusion The induction of clindamycin resistance is considerbly high. It suggested that the D-test should be routinly proformed in the erythromycin-resistant but clindamycin-senstive Staphylococcus in microbiological laboratories. The result of inducible clindamycin resistance should be reported so as to give the proofs for clinical physicians to used antibiotic correctly.