从骨科器械相关感染中分离出的凝固酶阴性葡萄球菌对替考拉宁和万古霉素的敏感性降低。
Decreased susceptibility to teicoplanin and vancomycin in coagulase-negative Staphylococci isolated from orthopedic-device-associated infections.
机构信息
EA3647, Université de Versailles Saint-Quentin-en-Yvelines, Garches.
出版信息
J Clin Microbiol. 2010 Apr;48(4):1428-31. doi: 10.1128/JCM.02098-09. Epub 2010 Feb 17.
Abstract
We studied 315 coagulase-negative Staphylococcus strains recovered prospectively during 240 surgical procedures (206 subjects) from proven or suspected device-associated bone and joint infections. Sixteen strains (5.1%) had decreased susceptibility to glycopeptides: 15 (12 S. epidermidis strains, 2 S. capitis strains, and 1 S. haemolyticus strain) to teicoplanin alone (MIC of 16 mg/liter, n = 9; MIC of 32 mg/liter, n = 6) and one (S. epidermidis) to both teicoplanin and vancomycin (MIC, 16 and 8 mg/liter, respectively). Decreased susceptibility to teicoplanin was more prevalent in "infecting" strains (i.e., strains recovered from >/=2 distinct intraoperative samples) than in "contaminants" (i.e., strains not fulfilling this criterion) (8.1% [12/149] versus 2.4% [4/166], respectively [P = 0.022]). One hundred percent (13/13) of S. epidermidis strains with decreased susceptibility to teicoplanin were resistant to methicillin (versus 112/173 [64.7%] for S. epidermidis strains susceptible to teicoplanin; P = 0.021).
摘要
我们前瞻性地研究了 240 例手术（206 例患者）中分离出的 315 株凝固酶阴性葡萄球菌，这些菌株均来自确诊或疑似与器械相关的骨和关节感染。16 株（5.1%）对糖肽类药物的敏感性降低：15 株（12 株表皮葡萄球菌、2 株头状葡萄球菌和 1 株溶血葡萄球菌）对替考拉宁（MIC 为 16mg/L，n=9；MIC 为 32mg/L，n=6）单独耐药，1 株（表皮葡萄球菌）对替考拉宁和万古霉素均耐药（MIC 分别为 16 和 8mg/L）。与污染菌（即未满足该标准的菌株）相比，感染菌（即从>2 个不同的术中样本中分离出的菌株）中替考拉宁耐药株更为常见（8.1%[12/149]与 2.4%[4/166]，P=0.022）。对替考拉宁耐药的 13 株表皮葡萄球菌全部对甲氧西林耐药（而对替考拉宁敏感的 173 株表皮葡萄球菌中有 112 株[64.7%]对甲氧西林耐药；P=0.021）。
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