Colakoğlu Sule, Alişkan Hikmet, Turunç Tuba, Demiroğlu Yusuf Ziya, Arslan Hande
Başkent Universitesi Tip Fakültesi, Mikrobiyoloji ve Klinik Mikrobiyoloji Anabilim Dali, Ankara.
Mikrobiyol Bul. 2008 Jul;42(3):407-12.
Empirical treatment options for staphylococcal infections have become limited, as the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) strains have increased. Clindamycin has been a useful option for treating skin and soft-tissue infections caused by MRSA. However, expression of inducible macrolide-lincosamide-streptogramin B resistance (MLS(B)i) to clindamycin could limit the effectiveness of this drug. The purpose of this study was to investigate the prevalence of inducible clindamycin resistance (MLS(B)i) in S. aureus strains isolated from clinical samples (wound, abscess, blood, sterile body fluids, upper respiratory tract samples, catheter). We prospectively collected sequential non-duplicated S. aureus isolates exhibiting erythromycin resistance and clindamycin susceptibility, as determined by disk diffusion method from September 2005 to August 2007 in Baskent University Adana Research and Practice Center. Testing for MLS(B)i was accomplished by the disk-diffusion induction test (D test). A total of 892 S. aureus isolates were collected during the study period. Of these, 226 were detected as erythromycin resistant-clindamycin susceptible by disk diffusion method. The prevalence of inducible clindamycin resistance in all S. aureus isolates and erythromycin resistant-clindamycin susceptible isolates were found as 19.4% (173/892) and 76.5% (173/226), respectively. Accurate susceptibility data are important for appropriate clindamycin therapy. Since inducible clindamycin resistance is not detected by standard susceptibility tests, application of D-test on a routine basis will be helpful to detect this resistance and to help effective use of clindamycin in staphylococcal infections.
由于耐甲氧西林金黄色葡萄球菌（MRSA）菌株的流行率增加，葡萄球菌感染的经验性治疗选择变得有限。克林霉素一直是治疗由MRSA引起的皮肤和软组织感染的有用选择。然而，对克林霉素的诱导型大环内酯-林可酰胺-链阳霉素B耐药性（MLS(B)i）的表达可能会限制这种药物的有效性。本研究的目的是调查从临床样本（伤口、脓肿、血液、无菌体液、上呼吸道样本、导管）中分离出的金黄色葡萄球菌菌株中诱导型克林霉素耐药性（MLS(B)i）的流行率。我们前瞻性地收集了2005年9月至2007年8月在巴斯肯特大学阿达纳研究与实践中心通过纸片扩散法确定表现出红霉素耐药和克林霉素敏感的连续非重复金黄色葡萄球菌分离株。通过纸片扩散诱导试验（D试验）完成对MLS(B)i的检测。在研究期间共收集了892株金黄色葡萄球菌分离株。其中，通过纸片扩散法检测到226株为红霉素耐药-克林霉素敏感。在所有金黄色葡萄球菌分离株和红霉素耐药-克林霉素敏感分离株中，诱导型克林霉素耐药的流行率分别为19.4%（173/892）和76.5%（173/226）。准确的药敏数据对于适当的克林霉素治疗很重要。由于标准药敏试验无法检测到诱导型克林霉素耐药性，常规应用D试验将有助于检测这种耐药性，并有助于在葡萄球菌感染中有效使用克林霉素。
