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金黄色葡萄球菌对喹诺酮类耐药的主动外排机制的研究

实验研究

金黄色葡萄球菌对喹诺酮类耐药的主动外排机制的研究

吴青萍,廖朝峰

(广东省深圳市宝安区人民医院,广东深圳

金黄色葡萄球菌对喹诺酮类耐药的主动外排机制的研究

518101)

[摘要] 目的 对临床分离株中主动外排机制介导耐药的流行情况进行调查,为临床合理

用药、耐药性控制及新型敏感抗菌药物的开发提供理论依据。方法 将金黄色葡萄球菌(金葡

菌)标准株AT CC25923及对喹诺酮类敏感临床株接种于含4 M I C 氧氟沙星的MH 琼脂平板

上(含或不含20mg/L 的利血平),观察利血平对诱导耐药出现的抑制作用,并测定诱导耐药株

对溴乙啶、氧氟沙星、环丙沙星的M IC(含或不含20mg/L 的利血平),观察利血平对诱导耐药株

M IC 的影响,用利血平抑制试验法测定临床上耐喹诺酮类金葡菌中主动外排机制的流行性。结

果 利血平可抑制喹诺酮类对金葡菌的诱导耐药率,可降低诱导耐药率的M IC 。利血平抑制试

验是检测金葡菌中主动外排机制简单直观的方法,临床上耐喹诺酮类金葡菌中约50%存在主动外排机制。结论 主

动外排是临床上金葡菌对喹诺酮类耐药的一种重要机制,利血平可抑制喹诺酮类对金葡菌的诱导耐药率,并可降低耐

药菌的M IC,与喹诺酮类可起协同抗菌作用。

[关键词] 金黄色葡萄球菌;敏感性;喹诺酮;主动外排机制

[中图分类号] R0378.11 [文献标识码] A [文章编号] 1008-8849(2005)13-1686-03

Study of active ef flux mechanism in staphylococcus aureus resistant to Quinolone

WU Q ing ping,LIA O Chao feng

(Bao an District People s Hospital,Shenzhen 518101,Guangdong,China)

Abstract:Objective It is to investigate the popular instance of t he activ e efflux mechanism in clinical dissociat ive strain

in or der to offer theoretical basis on clinical rational administration,r esistance control and the development of neot ype

aeschynomenous antibacter ials.Methods Staphylococcus aureus standar d strain AT CC25923and clinic aeschynomenous strain

to Quinolone were inoculated onto MH ag ar plate containing 4 M IC Oflox acin (containing 20mg/L Reserpine or not).T he

inhibiting action of Reser pine on induction resistance w as observed.T he M IC of the induction resistance str ain on ethidium

bromide (EB),O floxacin and Ciproflox acin (containing 20mg/L Reser pine or not)w as determined.T he influence of Reser

pine on the M IC of the induction r esistance str ain was observed.T he po pular instance of t he active efflux mechanism in resis

tance Quinolone staphylococcus aureus o n clinic was surv ey ed w ith Reser pine inhibition test.Results R eserpine can restrain

the induction resistance rate of Quinolone on staphy lococcus aureus and can debase t he M IC of t he induction resistance rate.

Reserpine inhibition test w as a simple and dir ect met hod deter mining the active efflux mechanism in staphylococcus aureus.

T he active efflux mechanism was existed on about 50%str ains of resistance Quinolone staphylococcus aur eus on clinic.C on

clusion Active efflux is an impo rtant mechanism of staphy lococcus aureus r esi stant to quinolone on clinic.Reserpine can re

str ain the induct ion resistance rate of Quinolone on staphylococcus aureus and debase the M IC of the resistance str ain.Reser

pine and Quino lone hav e cooperativity.

Key words:staphyloco ccus aur eus;sensibility ;Q uinolone;activ e efflux mechanism

[作者简介] 吴青萍(1964!),女,主管药师。 金黄色葡萄球菌(金葡菌)是一种重要的社区和医院获得

性病原菌,它可引起人体多部位的严重感染。近年来耐甲氧

西林金黄色葡萄球菌(M RSA)大量出现,并且对头孢菌素及

氨基糖甙类等抗菌药耐药菌逐年增多,严重限制了临床上抗

菌药物的选择范围[1]。喹诺酮类药物曾一度成为耐药金葡菌

感染的有效治疗药物,但进入临床不久,对喹诺酮耐药的金葡菌便大量出现[2]。为探讨主动外排机制在金葡菌对喹诺酮耐药中的作用并研究对抗其耐药的方法,笔者通过利血平抑制试验,观察利血平对诱导耐药株的出现及对已存在的耐药性是否有抑制作用,并检测临床分离金葡菌中主动外排机制的流行情况。1 实验资料

1 1 药物与试剂 氧氟沙星标准品由浙江裕康公司提供,纯

度99.1%;环丙沙星水剂0.2% 200mL/袋,购自德国拜耳公司;利血平标准品及溴乙啶粉由深圳晶美生物制品公司生∀1686∀现代中西医结合杂志Modern Journal of Integrated Traditional Chinese and Western Medicine 2005Jul,14(13)