Jansen B, Schumacher-Perdreau F, Pulverer G
Institute of Medical Microbiology and Hygiene, University of Cologne, Köln, Germany.
Zentralbl Bakteriol. 1995 Oct;282(4):402-8. doi: 10.1016/s0934-8840(11)80711-5.
The significance of grampositive bacteria, especially staphylococci and enterococci, as nosocomial pathogens has increased in the last decade. Furthermore, resistance to commonly used antibiotics like beta-lactams has also become more common and even resistance to glycopeptides has been observed. We evaluated the susceptibility of 150 staphylococcal clinical isolates (52 S. epidermidis, 52 S. haemolyticus, 10 S. saprophyticus, 10 S. hominis, 4 S. warneri, 4 S. simulans, 4 S. capitis and 14 S. aureus) and of 50 enterococci (49 E. faecalis, 1 E. faecium) to the glycopeptides, vancomycin and teicoplanin. The data from the agar dilution test used as reference method were compared with the results from the E test and the agar disk diffusion test. Concerning vancomycin, no resistance among all the staphylococcal isolates was observed whereas one single enterococcal strain (E. faecium) proved to be resistant. The overall resistance of staphylococcal isolates against teicoplanin was about 10.7% (15 S. haemolyticus, 1 S. epidermidis) being mainly due to the high proportion of S. haemolyticus strains (52 out of 150) among the staphylococcal isolates. Teicoplanin resistance among the enterococci was not detected. For vancomycin, a very close correlation between the MICs from the agar dilution test and the E test was noticed. As concerns teicoplanin, the MICs from the E-test were usually somewhat lower than those obtained by the agar dilution test. No correlation was found between the MICs of resistant and intermediate staphylococcal strains and the results from the teicoplanin agar disk diffusion test. For routine teicoplanin susceptibility testing of staphylococci, the determination of the MIC (e.g., by the E test) is much more reliable for detecting resistant strains than the agar disk diffusion test.
在过去十年中，革兰氏阳性菌，尤其是葡萄球菌和肠球菌作为医院病原体的重要性有所增加。此外，对常用抗生素如β-内酰胺类的耐药性也变得更加普遍，甚至观察到对糖肽类的耐药性。我们评估了150株葡萄球菌临床分离株（52株表皮葡萄球菌、52株溶血葡萄球菌、10株腐生葡萄球菌、10株人葡萄球菌、4株沃氏葡萄球菌、4株模仿葡萄球菌、4株头葡萄球菌和14株金黄色葡萄球菌）和50株肠球菌（49株粪肠球菌、1株屎肠球菌）对糖肽类、万古霉素和替考拉宁的敏感性。将用作参考方法的琼脂稀释试验数据与E试验和琼脂纸片扩散试验结果进行比较。关于万古霉素，在所有葡萄球菌分离株中未观察到耐药性，而仅有一株肠球菌菌株（屎肠球菌）被证明耐药。葡萄球菌分离株对替考拉宁的总体耐药率约为10.7%（15株溶血葡萄球菌、1株表皮葡萄球菌），主要是由于溶血葡萄球菌菌株在葡萄球菌分离株中所占比例较高（150株中有52株）。未检测到肠球菌对替考拉宁的耐药性。对于万古霉素，注意到琼脂稀释试验的MIC与E试验之间有非常密切的相关性。关于替考拉宁，E试验的MIC通常略低于琼脂稀释试验获得的MIC。在耐药和中介葡萄球菌菌株的MIC与替考拉宁琼脂纸片扩散试验结果之间未发现相关性。对于葡萄球菌的常规替考拉宁敏感性检测，测定MIC（例如通过E试验）在检测耐药菌株方面比琼脂纸片扩散试验可靠得多。
