女性泌尿生殖道的无乳链球菌耐药性分析

Drug resistance of Streptococcus agalactiae isolated from female urogenital tract

目的了解分离自女性泌尿生殖道的无乳链球菌的耐药性,为临床提供用药依据。方法收集泌尿生殖道标本进行常规培养,对分离所得无乳链球菌进行耐药性分析。结果共检出无乳链球菌77株,以女性<50岁女性占94.8%生殖道分泌物来源为主。抗菌药物敏感性试验结果显示,无乳链球菌对四环素耐药率最高(84.4%),其次是红霉素(63.6%)和克林霉素(29.9%)。此外,存在一定比例的左氧氟沙星(24.7%)、环丙沙星(24.7%)、呋喃妥因(1.3%)耐药,存在对环丙沙星、呋喃妥因和莫西沙星的中介菌株;未发现对替加环素、奎奴普丁/达福普汀、万古霉素、利奈唑胺、头孢曲松、氨苄西林和青霉素的耐药菌株。红霉素对克林霉素诱导耐药试验(D试验)阳性率75.0%,发现2株少见L-型耐药表型。结论青霉素仍可作为临床治疗无乳链球菌感染的首选药物;红霉素与克林霉素存在诱导型耐药,应引起对特殊耐药表型的重视。医院应密切观察细菌耐药性以防范多重耐药菌的出现。

Objective To investigate the drug resistance of Streptococcus agalactiae isolated from female urogenital tract,and to provide a reference for clinical antibiotic usage. Methods Samples were collected from urogenital tract among females,and the drug resistance of Streptococcus agalactiae isolated from female urogenital tract was evaluated. Results A total of 77 isolates of Streptococcus agalactiae were collected,mainly from the secretions of female urogenital tract in Department of Gynaecology and Obstetrics. There were 94.8% females under 50 years old. The susceptibility test showed that tetracycline had the highest susceptibility rate（84.4%）,followed by erythromycin（63.6%） and clindamycin（29.9%）. Some isolates were resistant to levo？oxacin（24.7%）,ciprofloxacin（24.7%） and nitrofurantoin（1.3%）,and some isolates had intermediate susceptibility to cipro？oxacin,nitrofurantoin and moxi？oxacin. The isolates being resistant to tigecycline,quinupristin/dalfopristin,vancomycin,linezolid,ceftriaxone,ampicillin and penicillin were not found. The positive rate of D-inhibition zone trail was 75.0%,and 2 isolates of special resistant L-phenotype were determined. Conclusions Penicillin remains the ？rst choice for the treatment of Streptococcus agalactiae infection. Inducible erythromycin-resistance and clindamycin-resistance exist. Hospitals should pay attention to special resistant phenotype and other bacterial drug resistance in order to prevent from multiple drug resistant isolates.