【关键词】 口恶唑烷酮;利奈唑胺; 万古霉素耐药; 屎肠球菌; vanA;VRE感染
【摘要】 目的 评价利奈唑胺对临床分离万古霉素敏感及耐药屎肠球菌的体外抗菌活性。方法 多重PCR法鉴定屎肠球菌万古霉素耐药基因类型，平皿二倍稀释法测定利奈唑胺等11种抗菌药物MIC值。结果 75株临床分离万古霉素耐药屎肠球菌均携带vanA基因。万古霉素敏感及耐药屎肠球菌对利奈唑胺均敏感，MIC范围1～2mg/L。与红霉素、氨苄西林、左氧氟沙星和利福平相比，万古霉素敏感及耐药屎肠球菌的耐药率均在80%以上。万古霉素敏感屎肠球菌对高浓度庆大霉素、高浓度链霉素、四环素和氯霉素的耐药率分别为80.2%、13.9%、38.6%和37.6%;万古霉素耐药屎肠球菌对上述4种药物的耐药率分别为64.5%、8.0%、18.5%和5.3%。结论 利奈唑胺对我国临床分离万古霉素敏感和耐药屎肠球菌均具有很好的体外抗菌活性。
The in vitro activity of linezolid against vancomycin susceptible
and resistant Enterococcus faecium
Li Yun, Zheng Bo, Liu Jian, Wang Shan,
Zhu Sainan, Xue Feng and Zhong Wei
(Institute of Clinical Pharmacology, First Hospital, Peking University, Beijing 100034)
ABSTRACT Objective To investigate in vitro antibacterial activity of linezolid against vancomycinsusceptible Enterococcus faecium (VSE) and vancomycinresistant Enterococcus faecium (VRE). Methods The van genes were detected by multiplex PCR and MICs of linezolid and other 10 agents were determined by the twofold agar dilution method. Result 75 VRE isolates were all carried vanA. All VSE and VRE isolates were susceptible to linezolid (MIC range 1～2mg/L), more than 80% of VSE and VRE isolates were resistant to erythromycin, ampicillin, levofloxacin and rifampin.The resistance rates of VSE to high level gentamycin, high level streptomycin, tetracycline and chloramphenicol were 80.2%, 13.9%, 38.6% and 37.6%, respectively. The resistance rates of VRE to the abovementioned agents were 64.5%, 8.0%, 18.5% and 5.3%, respectively. Conclusion Linezolid showed potent activity against vancomycinsusceptible and resistant E.faecium.
KEY WORDS Linezolid; Vancomycinresistance; Enterococcus faecium; vanA
肠球菌属引发的感染已占相当数量，且有逐年上升趋势。1999年Linden等[1]报道，在美国肠球菌属引发的感染占院内感染的12%，与肠球菌感染相关的病死率约13.1%，其中最严重、对患者威胁最大的是万古霉素耐药肠球菌(vancomycinresistant Enterococci，VRE)。万古霉素用来治疗革兰阳性菌引发的感染已有近50年历史。20世纪80年代末，欧美等国相继报道发现临床分离的VRE，我国近年万古霉素耐药肠球菌已经出现并且在逐渐增多[2，
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