Nakamura S, Nakashio S, Mikawa M, Yamakawa K, Okumura S, Nishida S
Microbiol Immunol. 1982;26(1):25-30. doi: 10.1111/j.1348-0421.1982.tb00150.x.
A total of 79 Clostridium difficile strains from healthy young and elderly adults, elderly patients without gastrointestinal disease, elderly patients receiving antibiotics without gastrointestinal complications, and elderly patients with antibiotic-associated diarrhea or pseudomembranous colitis were tested for their susceptibilities to 24 antimicrobial agents. All of the 79 strains were inhibited by low concentrations of rifampicin, metronidazole, fusidic acid, vancomycin, ampicillin, and penicillin G. Strains were highly resistant to aminoglycosides, trimethoprim, sulfamethoxazole, nalidixic acid, and cycloserine and often resistant to neomycin, cefoxitin, and cefalexin. Wide variations in the susceptibility of C. difficile strains to erythromycin, clindamycin, lincomycin, chloramphenicol, and tetracycline were found. Strains resistant to erythromycin, clindamycin, and lincomycin were more frequently found among strains isolated from elderly adults than those isolated from young adults, with particularly high frequency among strains isolated from elderly patients receiving antibiotics. None of the 23 strains isolated from healthy young adults was resistant to chloramphenicol. All of the 14 strains resistant to erythromycin, clindamycin, lincomycin, and chloramphenicol were sensitive to tetracycline and all of the 15 strains resistant to erythromycin, clindamycin, lincomycin, and tetracycline were sensitive to chloramphenicol. Only one out of 19 tetracycline, resistant strains was highly toxigenic, whereas 42 (70%) of the 60 sensitive strains were highly toxigenic.
对来自健康年轻人和老年人、无胃肠道疾病的老年患者、接受抗生素治疗且无胃肠道并发症的老年患者以及患有抗生素相关性腹泻或伪膜性结肠炎的老年患者的79株艰难梭菌菌株进行了24种抗菌药物的敏感性测试。所有79株菌株均被低浓度的利福平、甲硝唑、夫西地酸、万古霉素、氨苄西林和青霉素G抑制。菌株对氨基糖苷类、甲氧苄啶、磺胺甲恶唑、萘啶酸和环丝氨酸高度耐药，对新霉素、头孢西丁和头孢氨苄也常常耐药。发现艰难梭菌菌株对红霉素、克林霉素、林可霉素、氯霉素和四环素的敏感性差异很大。与从年轻人中分离出的菌株相比，从老年人中分离出的对红霉素、克林霉素和林可霉素耐药的菌株更为常见，在接受抗生素治疗的老年患者中分离出的菌株中频率尤其高。从健康年轻人中分离出的23株菌株均对氯霉素不耐药。对红霉素、克林霉素、林可霉素和氯霉素耐药的14株菌株均对四环素敏感，对红霉素、克林霉素、林可霉素和四环素耐药的15株菌株均对氯霉素敏感。19株四环素耐药菌株中只有1株具有高毒力，而60株敏感菌株中有42株（70%）具有高毒力。
