对克林霉素3种耐药表型的金黄色葡萄球菌的耐药性分析

摘要

目的:探讨金黄色葡萄球菌(staphylococcus aureus,SA)对克林霉素3种耐药表型菌株的分布及其耐药情况,以指导临床合理用药.方法:分析132株SA临床分离株的药物敏感试验结果,了解SA对克林霉素耐药表型及其不同耐药表型菌株对15种药物的耐药情况,质量控制参照《临床检验操作规程》(3版)和美国临床实验室标准化研究所标准.结果:132株SA对克林霉素3种耐药表型分别为敏感型(53株,占40.15％)、结构耐药型(57例,占43.18％)、诱导耐药型(22株,占16.67％),敏感型、结构耐药型的菌株数显著高于诱导耐药型,差异有统计学意义(x2=25.023,P=0.000).3种耐药表型菌株对莫西沙星、利奈唑烷、替加环素、万古霉素均无耐药,对左氧氟沙星、利福平和呋喃唑酮类抗菌药物的耐药率较低.结论:SA对克林霉素3种耐药表型分布不同,不同耐药表型菌株的耐药性不同,结构耐药型菌株的耐药性总体高于敏感型和诱导耐药型.%OBJECTIVE:To probe into the distribution and drug resistance of three kinds of drug-resistant phenotypes of Staphylococcus aureus(SA),so as to guide clinical rational drug application.METHODS:Outcomes of drug sensitivity test of 132 SA clinical isolated strains were analyzed,so as to investigate the drug resistance condition of SA resisted to clindamycin phenotypes and different phenotypes of strains resisted to 15 kinds of drugs.The quality control was conformed with Clinical Inspection Procedure(third edition)and Standardization Institute Standards of American Clinical Laboratory Association.RESULTS:Three kinds of drug-resistant phenotypes of 132 strains of SA resisted to clindamycin were respectively susceptibility type drug resistance(53 strains,accounted for 40.15％),constitutive type drug resistance(57 strains,accounted for 43.18％)and induced drug resistance(22 strains,accounted for 16.67％),numbers of susceptibility type and constitutive type drug resistance strains were significantlymore than that of the induced drug resistance,with statistically significant difference(x2=25.023,P=0.000).There was no drug resistance of three kinds of drug-resistant phenotypes to moxifloxacin,linezolid,tigecycline and vancomycin,and there were low drug resistances in levofloxacin,rifampicin and furazolidone.CONCLUSIONS:Different distribution of three kinds of drug-resistant phenotypes of clindamycin-resistance SA has different drug resistance,the resistance of SA to antimicrobials in constitutive type were higher than that in susceptibility type and induced resistant type.