目的 调查微量肉汤稀释法、纸片扩散试验(2种表型试验)检测葡萄球菌对克林霉素诱导耐药的现状(及其)耐药基因mecA、ermA、ermB、ermC、msrA在本地区的流行分布,指导临床合理使用抗生素.方法 通过革兰染色、凝聚因子、凝固酶试验、触酶试验和Vitek 2 compact鉴定菌株.PCR检测细菌的mecA、ermA、ermB、ermC、msrA耐药基因.结果 微量肉汤稀释法、纸片扩散试验检测葡萄球对克林霉素诱导耐药与基因检测有很好的一致性.ermC为葡萄球菌诱导克林霉素耐药的优势基因.ermC、ermA在S.aureus、S.epidermidi、S.haemolytic所占比例分别75.0%(81/108)、65.9%(91/138)、74.2%(92/124);21.3%(23/108)、22.5%(31/138)、15.3%(19/124).结论 2种表型方法 检测葡萄球对克林霉素诱导耐药试验与PCR检测耐药基因方法 符合率高,微量肉汤稀释法可用于自动化仪器、纸片扩散试验可用于常规试验.%Objective To investigate the current situation of detecting inducible clindamycin resistance in staphylococci by the broth microdilution method and the double disk diffusion method, and to understand the prevalence and the genotype distribution of resistance genes of mecA , ermA , ermB , ermC , msrA in our local area for the sake of rational application of antibiotics. Methods Identification of the strains was performed by the Grams stain , clumping factor, coagulase production tests , catalase tests , and the Vitek 2 compact. The mecA ,ermA,ermB,ermC,msrA resistance genes were detected by PCR. Results There was a good concordance between the broth microdilution method , the disk diffusion susceptibility test and the detection of resiatance genes. ermC was the predominant genetic determinant for the expression of inducible clindamycin resistance among staphylococci. The ermC and ermA of S. aureus , S. epidermidi, S. haemolytic were 75. 0％ ( 81/108) ,21. 3％ ( 23/108) ; 65. 9％ (91/138) ,22. 5％ ( 31/138) ;74. 2％ ( 92/124) ,15. 3％ ( 19/124) . respectively. Conclusion The coincidence rate is high between the two phenotypes and the detection of resistance genes by PCR for detecting inducible clindamycin resistance of staphylococci. The broth microdilution method may be used for automatic instruments. The disk diffusion susceptibility test may be used for the routine test.
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