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尿路上皮感染患者分离的腐生葡萄球菌和其他葡萄球菌的苯唑西林耐药性和抗菌药物敏感性分析。

Oxacillin resistance and antimicrobial susceptibility profile of Staphylococcus saprophyticus and other staphylococci isolated from patients with urinary tract infection.

机构信息

Department of Microbiology and Immunology, Botucatu Biosciences Institute, Universidade Estadual Paulista, Botucatu, SP 18618-970, Brazil.

出版信息

Chemotherapy. 2012;58(6):482-91. doi: 10.1159/000346529. Epub 2013 Mar 26.

Abstract

BACKGROUND

Staphylococcus saprophyticus is the second most frequent community-acquired causative agent of urinary tract infection (UTI). The objective of this study was to evaluate the susceptibility profile and resistance detection in Staphylococcus species. isolated from patients with UTI.

MATERIALS AND METHODS

The isolates were investigated using the disk diffusion method, Vitek I system, E-test®, and detection of the mecA gene.

RESULTS

Most isolates (76.2%) were resistant to oxacillin by the disk diffusion method, followed by those resistant to penicillin (72.2%). The oxacillin disk diffusion method, E-test, and Vitek I method showed higher sensitivity (94.4%) and lower specificity (28.9, 26.5, and 24.0%, respectively) than the cefoxitin disk diffusion test (sensitivity: 83.5%, specificity: 85.5%) for the detection of oxacillin resistance.

CONCLUSIONS

The large number of oxacillin-resistant isolates indicates that the breakpoint value recommended by the Clinical and Laboratory Standards Institute may overestimate oxacillin resistance in S. saprophyticus. Thus, changes in these guidelines are necessary for the correct detection of this resistance.

摘要

背景

腐生葡萄球菌是引起社区获得性尿路感染(UTI)的第二大常见病原体。本研究旨在评估从 UTI 患者中分离的葡萄球菌属的药敏谱和耐药检测情况。

材料与方法

采用纸片扩散法、Vitek I 系统、E 试验和 mecA 基因检测对分离株进行研究。

结果

大多数(76.2%)分离株对苯唑西林的药敏纸片扩散法耐药,其次是青霉素(72.2%)。药敏纸片扩散法、E 试验和 Vitek I 法对苯唑西林耐药的检测灵敏度(94.4%)高于头孢西丁药敏纸片扩散法(83.5%),但特异性(28.9%、26.5%和 24.0%)较低。

结论

大量耐苯唑西林的分离株表明,临床和实验室标准研究所推荐的折点值可能高估了腐生葡萄球菌对苯唑西林的耐药性。因此,有必要对这些指南进行修改,以正确检测这种耐药性。

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