淋病奈瑟菌临床分离株对抗菌药物敏感性及TEM-1基因质粒分型研究  

In vitro susceptibility to 5 antimicrobial agents and TEM-1 Genotyping of clinical strains of Neisseria gonorrhoeae*

作　　者：劳丽嫦 方镇强 吴文伟 郭炽星 蒋敏慧 徐碧红 吴兴中[5] 

机构地区：[1]广州市番禺区中心血站检验科,511400 [2]广州市番禺区慢性病防治站皮肤科,511400 [3]广州市番禺区石基人民医院检验科,511450 [4]广州市番禺区慢性病防治站检验科,511400 [5]广东省皮肤性病防治中心,广州510095

出　　处：《国际检验医学杂志》2012年第15期1801-1802,1805,共3页International Journal of Laboratory Medicine

基　　金：广州市番禺区科技计划资助项目(2011-Z-03-74)

摘　　要：目的检测2010～2011年度本地区临床分离的淋病奈瑟菌流行株对青霉素、四环素、大观霉素、头孢曲松和环丙沙星的敏感性,对质粒介导的产β-内酰胺酶淋球菌(PPNG)进行耐药质粒TEM-1基因分型。方法采用琼脂稀释法测定菌株对5种抗菌药物的最小抑菌浓度(MIC),判断敏感性按WHO西太区淋病奈瑟菌耐药性监测统一标准。用纸片酸度法检测PPNG菌株,多重PCR方法鉴定β-内酰胺酶质粒并进行TEM-1基因分型。结果 150株淋病奈瑟菌中检出105株对青霉素耐药(70%);四环素和环丙沙星耐药率分别为84%和98%;未发现对大观霉素和头孢曲松耐药菌株,但头孢曲松低敏率达到48%(72/150);青霉素﹑四环素和环丙沙星的MIC50及MIC90均已超过耐药标准,尤以青霉素和四环素为甚,其MIC50及MIC90均超过耐药标准的2倍和大于32倍。检出PPNG46株,阳性率为30.7%,耐药质粒TEM-1基因分型以亚洲型为主(91.3%,42/46),只有4株携带非洲型质粒。结论淋病奈瑟菌对青霉素、四环素和环丙沙星耐药率较高,对大观霉素和头孢曲松的敏感性较高,可作为治疗的首选药物;TEM-1基因质粒分型以亚洲型为主。Objective To assess the vitro susceptibility to 5 antimicrobial agents and TEM-1 genotypes of clinical strains of Neisseria gonorrhoeae（N.gonorrhoeae） isolated from this region from 2010 to 2011.Methods The agar dilution method was used to determine the minimum inhibitory concentrations（MIC） to 5 antibiotics,including penicillin G,tetracycline,ciprofloxacin,ceftriaxone and spectinomycin.The resistance of all strains to 5 antibiotics was interpreted according to criteria used in the project of surveillance of gonococcal antibiotic susceptibility in the WHO Western Pacific Region.Penicillinase（β-lactamase） producing N.gonorrhoeae（PPNG） was analyzed by the paper acidometric method.A multi-PCR was used to distinguish subtypes of TEM-1.Results 150 strains N.gonorrhoeae isolates,collected in this district,were studied.Penicillin-resistant rate was 70%（105/150）.The prevalence of tetracycline-and ciprofloxacin-resistance was 84% and 98%,while none of strains appeared to be resistant to ceftriaxone and spectinomycin,respectively.MIC50 and MIC90 of penicillin,tetracycline and ciprofloxacin were significantly higher than resistant standards,especially 2 and over 32 times higher for penicillin and tetracycline.46（30.7%） strains were PPNG.Subtyping TEM-1 gene of β-lactamase plasmids of PPNG showed that 42（91.3%） PPNGs carried the Asian-type plasmids,but only 4 African-type plasmids were found.Conclusion Resistance to penicillin,tetracycline and ciprofloxacin spread seriously in this district.Ceftriaxone and spectiomycin should be used as the first-line agents in treating gonorrhoea.The Asian-type β-lactamase plasmids in PPNG were dominated,while African-type plasmid was sporadic.

关 键 词：奈瑟球菌 淋病 抗药性 微生物 TEM-1基因型 Β-内酰胺酶 质粒 

分 类 号：R440[医药卫生—诊断学]