D 区检测法在检测革兰氏阳性菌诱导耐药性方面优于标准方法：沙特阿拉伯一家教学医院的前瞻性监测

Superiority of D-zone Testing Method over Standard Method to detect Rnducible Resistance in Gram Positive Bacteria: a Prospective Surveillance from a Teaching Hospital in Saudi Arabia.

作者信息

Somily Ali Mohammed, Babay Hanan Ahmed Habib

机构信息

Department of Pathology, Microbiology Unit, King Khalid University Hospital, College of Medicine, Riyadh, Saudi Arabia.

出版信息

Int J Health Sci (Qassim). 2008 Jul;2(2):8-16.

PMID:21475484

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3068738/

Abstract

OBJECTIVE

In this prospective study, we determined phenotypic resistance to erythromycin among gram positive bacteria.

METHODS

BACTERIAL ISOLATES WERE IDENTIFIED BY CONVENTIONAL METHODS AND BY THE MICROSCAN: D-test zone was performed according to the Clinical and Laboratory Standards institutes (CLSI) recommendations to determine inducible resistance to clindamycin on gram positive bacteria isolated from different clinical specimens. Bacterial isolates included : group A streptococci (GAS), group B streptococci (GBS), viridans streptococci, S.pneumoniae, Staphylococcus aureus (S.aureus) (both methicillin susceptible (MSSA) and methicillin resistant (MRSA).

RESULTS

A total of 1072 gram positive bacterial isolates were tested. The majority was from swabs collected from outpatient clinics. Erythromycin resistance was 8/23 (35%) for S. pneumoniae, 12/91(13%) for GAS and 17/300(5.7%) for GBS. All GAS and viridans streptococci possessed the efflux phenotype only, 8(8.8% and 1(20%), respectively. For GBS, cMLS(B) was 11(3.7%), 3 (1%) iMLS(B) and 2(0.33%) were of efflux phenotype. All S.pneumoniae strains possessed cMLS(B) phenotype. Seventy five isolates (16.3%) of MSSA were resistant to erythromycin compared to 160(83%) of MRSA. The majority of MSSA, 31/460 (6.7%) had an efflux phenotype while 26/460(5.6%) were of cMLS(B) and 19/460(4%) iMLS(B) phenotypes. Constitutive MLS(B) was the most predominant resistant phenotype, 152/193(78.8%) among MRSA.

CONCLUSION

D-test zone should be considered for routine testing to detect inducible clindamycin resistance among significant gram positive bacteria.

摘要

目的

在这项前瞻性研究中，我们测定了革兰氏阳性菌对红霉素的表型耐药性。

方法

采用常规方法和MicroScan对细菌分离株进行鉴定：根据临床和实验室标准协会（CLSI）的建议进行D试验区域检测，以确定从不同临床标本中分离出的革兰氏阳性菌对克林霉素的诱导性耐药性。细菌分离株包括：A组链球菌（GAS）、B组链球菌（GBS）、草绿色链球菌、肺炎链球菌、金黄色葡萄球菌（S.aureus）（包括甲氧西林敏感株（MSSA）和甲氧西林耐药株（MRSA））。

结果

共检测了1072株革兰氏阳性菌分离株。大多数分离株来自门诊采集的拭子。肺炎链球菌对红霉素的耐药率为8/23（35%），GAS为12/91（13%），GBS为17/300（5.7%）。所有GAS和草绿色链球菌仅具有外排表型，分别为8株（8.8%）和1株（20%）。对于GBS，cMLS(B)为11株（3.7%），iMLS(B)为3株（1%），外排表型为2株（0.33%）。所有肺炎链球菌菌株均具有cMLS(B)表型。75株（16.3%）MSSA对红霉素耐药，而MRSA为160株（83%）。大多数MSSA，31/460（6.7%）具有外排表型，而26/460（5.6%）为cMLS(B)表型，19/460（4%）为iMLS(B)表型。组成型MLS(B)是MRSA中最主要的耐药表型，占152/193（78.8%）。