Cirak M Y, Sultan N
Gazi University, Faculty of Medicine, Department of Microbiology, Beşevler, Ankara, Turkey.
Acta Microbiol Pol. 1998;47(3):267-73.
Enterococcus spp. have become the third most common cause of nosocomial infections. High-level aminoglycoside resistance (HLAR), an important clinical concern, has been associated with some species of enterococci. The synergistic effect obtained by the combination of aminoglycosides with penicillin or vancomycin disappears in strains that show high-level resistance (HLR) to the aminoglycosides. We evaluated the agar dilution and high content disk diffusion tests for the detection of HLAR for 60 isolated enterococci. In our study 4 strains of Enterococcus faecalis (6.6%) and 8 strains of Enterococcus faecium (13.3%), totally 20% were found to be highly resistant to gentamicin; 2 strains of E. faecalis (13.3%), 8 strains of E. faecium (3.3%), totally 16.6% showed HLR to streptomycin by agar dilution method and the same rates were found by high-content disk diffusion method. 2 strains of E. faecalis (3.3%), 4 strains of E. faecium (6.6%), totally 10% showed vancomycin resistance by agar dilution method. The ratio for beta lactamase activity was found to be 26.6% for E. faecalis and 3.3% for E. faecium. Our results demonstrate that high-content disk diffusion test should be performed by using both gentamicin and streptomycin in routine screening of HLAR among enterococci and the determination of beta lactamase activity at the same time is also useful for detecting resistance to a beta lactam agent.
肠球菌已成为医院感染的第三大常见病因。高水平氨基糖苷类耐药性（HLAR）是一个重要的临床问题，与某些肠球菌种类相关。氨基糖苷类与青霉素或万古霉素联合使用所获得的协同效应在对氨基糖苷类表现出高水平耐药（HLR）的菌株中消失。我们评估了琼脂稀释法和高内涵纸片扩散法对60株分离出的肠球菌进行HLAR检测的效果。在我们的研究中，发现4株粪肠球菌（6.6%）和8株屎肠球菌（13.3%），总共20%对庆大霉素高度耐药；通过琼脂稀释法，2株粪肠球菌（3.3%）、8株屎肠球菌（13.3%），总共16.6%对链霉素表现出HLR，高内涵纸片扩散法得出的比例相同。通过琼脂稀释法，2株粪肠球菌（3.3%）、4株屎肠球菌（6.6%），总共10%表现出对万古霉素耐药。粪肠球菌的β-内酰胺酶活性比例为26.6%，屎肠球菌为3.3%。我们的结果表明，在对肠球菌进行HLAR的常规筛查中，应同时使用庆大霉素和链霉素进行高内涵纸片扩散试验，同时测定β-内酰胺酶活性对于检测对β-内酰胺类药物的耐药性也很有用。
