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目的 为防止临床耐万古霉素耐甲氧西林金黄色葡萄球菌(M RSA)的产生。方法 采用4 倍万古霉素(VNC) MIC和去甲万古霉素(NVNC) MIC 分别对M RSA 进行体外耐药诱导;以琼脂双倍稀释法测定诱导前、后细菌药敏。结果 20 株MRSA 分别经4 倍VNC M IC 和NVNC MIC 非连续性诱导培养20 代,无耐VNC 或NVNC M RSA 变异株产生;但经10 次以上诱导培养后,VNC和NVNC分别对MRSA 的抗生素后效作用消失。结论 VNC 或NVNC诱导产生耐VNC MRA 或耐NVNC MRSA 相当困难,但随着培养诱导次数增多,MRSA对VNC、NVNC或NVNC能产生一定耐受性改变。提示随着VNC临床实用价值增高、范围扩大及次数增多,诱导产生耐VNC或NVNC MRSA 可能性会越来越大,故强调尽量减少临床VNC或NVNC使用尤为必要
Objective To prevent the clinical development of vancomycin-resistant methicillin-resistant Staphylococcus aureus (M RSA). Methods The drug resistance of M RSA was induced in vitro by using MIC of 4 times of vancomycin (VNC) and MIC of nornicillin (NVNC) respectively. The drug susceptibility of bacteria before and after induction was determined by agar double dilution method. Results 20 strains of MRSA were induced by 4 times VNC M IC and NVNC MIC non-continuous culture for 20 generations, respectively, and no resistant VNC or NVNC M RSA mutant strains were produced. However, after 10 or more induction cultures, VNC and NVNC were respectively resistant to MRSA antibiotics After effects disappear. Conclusions VNC or NVNC is quite difficult to induce VNC MRA or NVNC MRSA. However, MRSA can produce certain tolerance to VNC, NVNC or NVNC with the increase of induction times. It is indicated that with the clinical value of VNC increased, the scope of the expansion and the number of times, the induction of resistance to VNC or NVNC MRSA may be more and more, it emphasizes the need to minimize the use of clinical VNC or NVNC