Nachamkin I, Axelrod P, Talbot G H, Fischer S H, Wennersten C B, Moellering R C, MacGregor R R
Department of Pathology and Laboratory Medicine, University of Pennsylvania School of Medicine, Philadelphia 19104-4283.
J Clin Microbiol. 1988 Jul;26(7):1287-91. doi: 10.1128/jcm.26.7.1287-1291.1988.
Enterococci isolated from different body sites were tested for high-level gentamicin resistance. A total of 259 enterococcal isolates were screened for resistance (MIC, greater than 2,000 micrograms/ml) by a broth-tube method. Thirty-nine (15.1%) were found to exhibit resistance and were confirmed by agar screening (1,000 micrograms/ml) and agar dilution MIC determinations. The majority of isolates also showed high-level resistance to kanamycin and streptomycin. The remaining isolates showed high-level resistance to gentamicin and kanamycin but not streptomycin. Synergy testing of several isolates confirmed the correlation between lack of synergy and high-level resistance. A retrospective clinical review was performed. Most patients had a source of definite or likely infection (79%). Serious infections such as endocarditis or meningitis were not observed during the course of this study. Retrospective clinical data suggest that in cases not involving endocarditis or meningitis, neither infection refractory to therapy nor relapse of infection is a common sequela of infection with gentamicin-resistant enterococci in hospitalized patients.
对从不同身体部位分离出的肠球菌进行了高水平庆大霉素耐药性检测。采用肉汤管法对总共259株肠球菌分离株进行耐药性筛查（最低抑菌浓度，大于2000微克/毫升）。通过琼脂筛选（1000微克/毫升）和琼脂稀释最低抑菌浓度测定，发现39株（15.1%）表现出耐药性并得到确认。大多数分离株还对卡那霉素和链霉素表现出高水平耐药性。其余分离株对庆大霉素和卡那霉素表现出高水平耐药性，但对链霉素不耐药。对几株分离株进行的协同试验证实了缺乏协同作用与高水平耐药性之间的相关性。进行了回顾性临床评估。大多数患者有明确或可能的感染源（79%）。在本研究过程中未观察到诸如心内膜炎或脑膜炎等严重感染。回顾性临床数据表明，在不涉及心内膜炎或脑膜炎的病例中，治疗难治性感染或感染复发并非住院患者感染庆大霉素耐药肠球菌后的常见后遗症。
