de Neeling A J, van Leeuwen W J, Schouls L M, Schot C S, van Veen-Rutgers A, Beunders A J, Buiting A G, Hol C, Ligtvoet E E, Petit P L, Sabbe L J, van Griethuysen A J, van Embden J D
National Institute of Public Health and the Environment, Bilthoven, The Netherlands.
J Antimicrob Chemother. 1998 Jan;41(1):93-101. doi: 10.1093/jac/41.1.93.
An electronic surveillance network for monitoring antibiotic resistance in The Netherlands has been in operation since 1989. Seven public health laboratories participate and the system covers about 25% of all bacteriological determinations in The Netherlands. This paper reports the results of staphylococci isolated in the period 1989-1995. About 0.3% of the Staphylococcus aureus isolates in the study period were resistant to methicillin. This low percentage may be due to the restrictive use of antibiotics and to strict isolation measures aimed at eradicating methicillin-resistant S. aureus. Low frequencies of resistance among methicillin-resistant S. aureus were found for vancomycin (0%), chloramphenicol (11%), cotrimoxazole (11%), mupirocin (3% low-level resistance) and fusidic acid (7%). Twenty-one percent of the coagulase-negative staphylococci were resistant to methicillin. Low frequencies of resistance among these methicillin-resistant coagulase-negative staphylococci were those to vancomycin (0.4%), nitrofurantoin (2%), doxycycline (20%) and amikacin (20%). Coagulase-negative staphylococci from cerebrospinal fluid, blood and skin were less often resistant to quinolones than isolates from respiratory tract, faeces and urine. A significant increase in resistance of coagulase-negative staphylococci to methicillin, erythromycin, gentamicin and ciprofloxacin was observed in the investigated period but the resistance to doxycycline and co-trimoxazole decreased in the last few years. To confirm the determination of methicillin resistance and coagulase production, a PCR method was developed which detects both the mecA and the coagulase gene. The results of the PCR method correlated well with the methicillin MIC as determined by an agar-dilution method.
自1989年起，荷兰便开始运行一个用于监测抗生素耐药性的电子监测网络。有7家公共卫生实验室参与其中，该系统覆盖了荷兰约25%的细菌学检测。本文报告了1989年至1995年期间分离出的葡萄球菌的检测结果。在研究期间，约0.3%的金黄色葡萄球菌分离株对甲氧西林耐药。这一低比例可能归因于抗生素的限制性使用以及旨在根除耐甲氧西林金黄色葡萄球菌的严格隔离措施。耐甲氧西林金黄色葡萄球菌对万古霉素（0%）、氯霉素（11%）、复方新诺明（11%）、莫匹罗星（3%低水平耐药）和夫西地酸（7%）的耐药频率较低。21%的凝固酶阴性葡萄球菌对甲氧西林耐药。这些耐甲氧西林凝固酶阴性葡萄球菌对万古霉素（0.4%）、呋喃妥因（2%）、多西环素（20%）和阿米卡星（20%）的耐药频率较低。来自脑脊液、血液和皮肤的凝固酶阴性葡萄球菌对喹诺酮类药物的耐药性低于来自呼吸道、粪便和尿液的分离株。在调查期间，观察到凝固酶阴性葡萄球菌对甲氧西林、红霉素、庆大霉素和环丙沙星的耐药性显著增加，但在过去几年中对多西环素和复方新诺明的耐药性有所下降。为了确证甲氧西林耐药性和凝固酶产生的检测结果，开发了一种PCR方法，可同时检测mecA基因和凝固酶基因。PCR方法的结果与琼脂稀释法测定的甲氧西林MIC结果相关性良好。
