Sahm D F, Kissinger J, Gilmore M S, Murray P R, Mulder R, Solliday J, Clarke B
Clinical Microbiology Laboratory, University of Chicago, Illinois 60637-1463.
Antimicrob Agents Chemother. 1989 Sep;33(9):1588-91. doi: 10.1128/AAC.33.9.1588.
Vancomycin resistance exhibited by Enterococcus faecalis isolates V583, V586, and V587 is described. The vancomycin MICs ranged from 32 to 64 micrograms/ml. Although resistant to vancomycin, the isolates were susceptible to teicoplanin (MIC, less than or equal to 0.5 micrograms/ml). Such a glycopeptide susceptibility profile has not been previously described for E. faecalis. Time kill studies showed that vancomycin resistance adversely affected the synergistic activity that vancomycin and aminoglycoside combinations usually demonstrate against enterococci. However, the ability to detect vancomycin resistance varied with the susceptibility testing method used. Whereas broth microdilution, broth macrodilution, and agar dilution methods detected resistance, disk-agar diffusion and the AutoMicrobic system Gram-Positive GPS-A susceptibility card (Vitek Systems Inc., Hazelwood, Mo.) did not. To detect vancomycin resistance reliably and establish the incidence of such E. faecalis isolates, adjustments in some susceptibility testing methods may be necessary.
描述了粪肠球菌分离株V583、V586和V587所表现出的万古霉素耐药性。万古霉素的最低抑菌浓度（MIC）范围为32至64微克/毫升。尽管这些分离株对万古霉素耐药，但它们对替考拉宁敏感（MIC小于或等于0.5微克/毫升）。这种糖肽类药敏谱此前尚未在粪肠球菌中描述过。时间杀菌研究表明，万古霉素耐药性对万古霉素和氨基糖苷类药物联合通常表现出的针对肠球菌的协同活性有不利影响。然而，检测万古霉素耐药性的能力因所使用的药敏试验方法而异。肉汤微量稀释法、肉汤常量稀释法和琼脂稀释法能检测到耐药性，而纸片琼脂扩散法和自动微生物系统革兰氏阳性GPS - A药敏卡（Vitek系统公司，密苏里州黑兹尔伍德）则不能。为了可靠地检测万古霉素耐药性并确定此类粪肠球菌分离株的发生率，可能需要对一些药敏试验方法进行调整。
