2000-2004年成都地区淋球菌耐药性监测  

Surveillance of antimicrobial susceptibility of Neisseria gonorrhoeae in Chengdu,2000～2004

作　　者：雍刚[1] 杨曦[1] 谭俊[1] 喻林冲[1] 廖巫山[1] 杨建琼[1] 

机构地区：[1]四川省皮肤病性病防治研究所,成都610031

出　　处：《中国艾滋病性病》2006年第3期242-244,220,共4页Chinese Journal of Aids & STD

摘　　要：目的检测成都地区2000～2004年淋球菌耐药菌株的流行情况及变迁。方法用纸片酸度定量法测定β-内酰胺酶。用琼脂稀释法测定菌株对青霉毒、四环素、环丙沙星、大观霉素、头孢曲松钠等5种抗生素的最小抑菌浓度（MIC）。结果2000～2004年5年间，978株菌对青霉素和环丙沙星的耐药率分别为88．14％～99．08％和93．87％～99．44％，其MIC50、MIC90及MIC范围均无明显变化，均未发现敏感株；对头孢曲松敏感，2000～2004年未检出耐药株，其MIG0、MIC90及MIC范围有逐渐降低的趋势。5年来共检出13株耐大观霉素菌株；产β-内酰胺酶菌株（PPNG）和耐四环素淋球菌（TRNG）检出率分别为78．02％和57．57％，均高于同期全国其它城市。2004年PPNG的检出率高达91．93％，与前4年相比显著上升（χ^2=37．16，P〈0．005），TRNG检出率近2年比前3年略有下降（χ^2=14．81，P〈0．005）。结论成都地区淋球菌耐药情况非常严重，青霉素、四环素、环丙沙星已不能作为本地区治疗淋病的药物，推荐大观霉素和头孢曲松作为本地区治疗淋病的首选药物，应对淋球菌的耐药性进行长期监测。Objective To investigate the prevalence of antibiotic resistance of Neisseria gonorhoeae isolates in Chengdu from 2000 to 2004. Methods B-lactamase was determined by paper acidometric method,and minimum inhibitory concentrations（MICs） of 5 antibiotics, penicillin, tetracycline, spectinomycin, ciprofloxacin and ceftriaxone to Neisseria gonorrhoeae isolates were determined by agar dilution method. Results The resistant rates of 978 N. gonorrhoeae strains to penicillin and ciprofloxacin were 88.14% - 99.08 % and 93.87 96 - 99.44% , respectively.There was no significant changes of MIC50 and MIC90 of the two antibiotics over the last 5 years. The isolates were sensitive to ceftriaxone. No resistant isolates were found,and the rates of MIC50 and MIC90 were decreased gradually during the period. Thirteen strains resistant to spectinomycin were detected in 5 years,The positive rates of PPNG and TRNG were 78.02 % and 57.57 %, respectively, which were higher than those in other domestic cities during the same period. PPNG accounted for as high as 91.93 % of all isolates in 2004 （P〈0.005）, but TRNG declined sig：aificantly in the recent 2 years（ P〈0. 005）. Conclusion The situation of antibiotic resistance of Neisseria is eftremely serious in Chengdu, and penicicin, terecycline or ciprofloxacin can not be used in treating gonorrhea. Spectinomycin and ceftriaxone should be used as the first-line agents. The surveillance of antibiotic resistance of Neisseria gonorrhoeae should be continued.

关 键 词：淋病奈瑟菌 耐药 抗生素 

分 类 号：R378.16[医药卫生—病原生物学]