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[金黄色葡萄球菌:采用扩散法对固有耐药性的新检测]

[Staphylococcus aureus: new detection of intrinsic resistance using the diffusion method].

作者信息

Mougeot C, Guillaumat-Tailliet J, Libert J M

机构信息

Laboratoire de bactériologie, centre chirurgical Marie-Lannelongue, 133, avenue de la Résistance, 92350 Le Plessis, Robinson, France.

出版信息

Pathol Biol (Paris). 2001 Apr;49(3):199-204. doi: 10.1016/s0369-8114(01)00129-8.

Abstract

Because of an heterogeneously-expressed resistance among methicillin-resistant Staphylococcus aureus strains the conditions for antibiogram determination had rapidly to be modified so as to improve their detection. The newly recommended conditions (incubation at +30 degrees C or on hypersalted agar medium) remain widely used at the moment, although they appear to be more and more often badly adapted, particularly because of the recently-observed renewed outbreak of wild strains with a weak in vitro phenotypic expression. It is the reason why we searched for a new and more reliable phenotypic method although still accessible for any laboratory. Sixty-five strains of Staphylococcus aureus entered the study. The absence or presence of mecA gene was previously investigated by gene amplification. These strains were of various origins and had often caused difficulties for the detection of intrinsic resistance to methicillin on the antibiogram. Our results confirm the failures of the classical methods (false negative results at +30 degrees C, false negative or positive results on hypersalted agar medium incubated at +37 degrees C). They also allow to propose a new method which relies on the determination of the susceptibility to cefoxitin using the usual conditions for antibiogram determination. In our series of strains, this new method proved to widely improve both the sensitivity and the susceptibility for the detection of methicillin-resistance by diffusion on the antibiogram.

摘要

由于耐甲氧西林金黄色葡萄球菌菌株之间存在异质性表达的耐药性,因此必须迅速修改药敏试验的条件,以提高对其的检测能力。目前,新推荐的条件(在30℃下培养或在高盐琼脂培养基上培养)仍被广泛使用,尽管它们似乎越来越难以适用,特别是因为最近观察到野生菌株再次爆发,其体外表型表达较弱。这就是我们寻找一种新的、更可靠的表型方法的原因,尽管任何实验室都可以采用。65株金黄色葡萄球菌进入研究。之前通过基因扩增研究了mecA基因的有无。这些菌株来源各异,在药敏试验中检测对甲氧西林的固有耐药性时常常遇到困难。我们的结果证实了经典方法的失败(在30℃下出现假阴性结果,在37℃下培养的高盐琼脂培养基上出现假阴性或阳性结果)。它们还使我们能够提出一种新方法,该方法依赖于使用药敏试验的常规条件来测定对头孢西丁的敏感性。在我们的菌株系列中,这种新方法被证明在药敏试验中通过扩散检测耐甲氧西林性时,大大提高了敏感性和特异性。

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