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目的了解医院内感染可诱导克林霉素耐药葡萄球菌的发生率及常用抗菌药物对葡萄球菌的体外抗菌活性和联合药敏实验。方法细菌鉴定应用VITEK全自动细菌鉴定分析系统;药敏试验采用KB纸片法和琼脂平板稀释法,按CLSI规定的标准进行;用D-试验检测可诱导克林霉素耐药的发生率。结果2005年7月至2006年4月从临床各种感染标本中分离得到113株葡萄球菌,其中iMLSB表型(D-试验阳性)占34.5%;MSB表型(红霉素R,克林霉素S)占16.8%;cMLSB表型(红霉素R,克林霉素R)占41.6%;红霉素耐药克林霉素敏感表型葡萄球菌58株中D试验阳性率为67.2%;D-试验阳性葡萄球菌对万古霉素、左氧氟沙星、阿米卡星、头孢唑林的MIC90分别为2.0、8.0、4.0、16(mg/L),万古霉素与左氧氟沙星、阿米卡星、头孢唑林联合药敏结果MIC90均为1.0(mg/L)。结论医院内感染诱导型克林霉素葡萄球菌的发生率已越来越高,临床应根据细菌实验室的耐药表型检测合理应用抗菌药物。
Objective To understand the incidence of Clindamycin-resistant Staphylococcus aureus in hospital and the antibacterial activity of commonly used antibacterial agents against Staphylococcus aureus and the combined susceptibility test. Methods Bacterial identification was performed by VITEK automatic bacterial identification system. Susceptibility testing was performed by KB disk method and agar plate dilution method according to the CLSI standard. The incidence of clindamycin-resistant drug-resistant was detected by D-test. Results From July 2005 to April 2006, 113 strains of staphylococci were isolated from clinical specimens. The iMLSB phenotype (positive for D-test) accounted for 34.5%. The phenotypes of MSB (erythromycin R, S) accounted for 16.8%; cMLSB phenotype (erythromycin R, clindamycin R) accounted for 41.6%; erythromycin resistant Clindamycin sensitive Staphylococcus aureus 58 in the D test positive rate was 67.2% The MIC90 of D-test positive Staphylococcus aureus to vancomycin, levofloxacin, amikacin and cefazolin was 2.0, 8.0, 4.0, 16 mg / L, vancomycin and levofloxacin, amikacin, Cefazolin combined susceptibility results MIC90 are 1.0 (mg / L). Conclusion The incidence of inducible clindamycin-producing staphylococci in hospitals has been increasing. Clinically, antimicrobial agents should be applied reasonably according to the drug resistance phenotypes detected in bacterial laboratories.