克林霉素誘導(dǎo)型耐藥葡萄球菌體外抗菌活性研究

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1、克林霉素誘導(dǎo)型耐藥葡萄球菌體外抗菌活性研究?作者：徐修禮仇王斌孫怡群樊新【摘要】?目的了解醫(yī)院內(nèi)感染可誘導(dǎo)克襝林霉素耐藥葡萄球菌的發(fā)生尺率及常用抗菌藥物對(duì)葡萄球敘菌的體外抗菌活性和聯(lián)合藥敏實(shí)驗(yàn)。方法細(xì)菌鑒定應(yīng)用訇VITEK全自動(dòng)細(xì)菌鑒定舡分析系統(tǒng)；藥敏試驗(yàn)采用K噠B紙片法和瓊脂平板稀釋法芯，按CLSI規(guī)定的標(biāo)準(zhǔn)進(jìn)行；用D試驗(yàn)檢測(cè)可誘導(dǎo)圖克林霉素耐藥的發(fā)生率。結(jié)勿果XX年7月至XX年4月端從臨床各種感染標(biāo)本中分離得到113株葡萄球菌，其棺中iMLSB表型(D試盟驗(yàn)陽(yáng)性)占%；MSB表型泥(紅霉素R，克林霉素S)遴占%；cMLSB表型(紅奎霉

2、素R，克林霉素R)占%冶；紅霉素耐藥克林霉素敏感轤表型葡萄球菌58株中D試擋驗(yàn)陽(yáng)性率為%；D試驗(yàn)陽(yáng)賠性葡萄球菌對(duì)萬(wàn)古霉素、左籃氧氟沙星、阿米卡星、頭孢埃唑林的MIC90分別為、擾、、16(mg/L)，萬(wàn)拉古霉素與左氧氟沙星、阿米屏卡星、頭孢唑林聯(lián)合藥敏結(jié)果MIC90均為(mg/腐L)。結(jié)論醫(yī)院內(nèi)感染誘導(dǎo)θ型克林霉素葡萄球菌的發(fā)生弄率已越來越高，臨床應(yīng)根據(jù)細(xì)菌實(shí)驗(yàn)室的耐藥表型檢測(cè)淅合理應(yīng)用抗菌藥物?！娟P(guān)刈鍵詞】?葡萄球菌；克林霉娠素；紅霉素；抗菌藥物；Dｍ試驗(yàn)；聯(lián)合藥敏試驗(yàn)；耐葦藥性ABSTRACT?臟Objective?Toinvesti

3、gatet胚h(yuǎn)eincidenceoぜ9/9finduciblecl⒘indamycinresistantstaph述ylococcusinnosocomialinfＩection,andan俁alyzeinvitro訖activityofth尷eroutineanti苠biotics(alon秫eorincombina唄tion)against刎staphylococcus.?Methods?橢UseautomaticsystemVITEKt祆oidentifyand珞analyzetheba氆cteria;Kirby倜Baucerm

4、etho縻dandagardilu刀tionmethodtodetectdrugsu颮sceptibility九followingCLSIstandards;a項(xiàng)ndDTesttode豆tecttheincid憋enceofinduci佝bleclindamyc舾inresistantΜstaphylococc囂us.?Results?穆Inthe113stra俗insofstaphylococcusisola燔tedfromtheva爾riousclinica潢lsamplesduri畝ngJuly,XXand諶April,XX,amo

5、冽ngiMSB(DTestispositive.),MSB(ERR,C狺LS)andcMLSB瘠(ERR,CLS)p嘮henotypeswer鯨e%,%and%resp積ectively.The朵positiveinci義denceinDTesビtwas%with58samplesofstapㄟh(yuǎn)ylococcuswh碣ichwassuscep艸tibletoclindamycinwhiler撼esistanttoer鮑ythromycin.T耐heMIC90ofvan濱comycin,levo碧floxacin,ami折kac

6、inandcefa冷zolinagainst麼Dtestpositi得vestaphylococcuswere,,,1羹6mg/Lrespect掠ively.TheMIC乒90ofcombined闕drugsensitiv⑺ityresultofl淳evofloxacin,巷amikacin,cef黝azolinwereal豢lmg/Lwhencom禧binedwithvan＾comycin.Conc縞lusions?Thei緲ncidenceofin蘭fectionwiths７taphylococcu囹swasgrowing,襞whichwa

7、sposs習(xí)ibletoinduce熙drugresistan梓cetoclindamyцcininnosocom睿9/9ialinfections.Theclinica棺luseofantimicrobialagentshouldfollow焚theinstructi冪onofthedrugr釤esistancephe噠notypegivenbｔythebacteria爻llaboratory.坐KEYWORDS?Staphylococcus菽;?Clindamyci曦n;?Erythromy鏵cin;?Antimic錚robialage

8、nt;?DTest;?Com昨biningdrugsu渲sceptibility膪test;?Drugre傳sista