淋病奈瑟菌的耐药性及分子流行病学观察  

Drug Resistance and Molecular Epidemiology of Neisseria gonorrhoeae

作　　者：周海永 张传领[3] 金百冶[1] ZHOU Haiyong;ZHANG Chuanling;JIN Baiye(Department of Urinary Surgery,the First Affiliated Hospital,Zhejiang University School of Medicine,Hangzhou 310003,China;Department of Urinary Surgery,Zhejiang Hospital,Hangzhou 311202,China;Department of Clinical Laboratory ,Zhejiang Xiaoshan Hospital ,Hangzhou311202,China)

机构地区：[1]浙江大学医学院附属第一医院泌尿外科,浙江杭州310003 [2]浙江医院泌尿外科 [3]浙江萧山医院检验科,浙江杭州311202

出　　处：《中国皮肤性病学杂志》2018年第12期1400-1403,共4页The Chinese Journal of Dermatovenereology

摘　　要：目的探讨临床分离的淋病奈瑟菌(淋球菌)对常用抗菌药物的耐药性及分子流行特征。方法收集2015-2016年本院临床分离的淋球菌,采用琼脂稀释法检测青霉素、四环素、大观霉素、环丙沙星、头孢曲松、头孢克肟、阿奇霉素的最小抑菌浓度(MIC),头孢噻吩纸片法检测产青霉素酶淋球菌(PPNG),淋球菌多抗原序列(NG-MAST)确定菌株的ST。结果共分离出126株淋球菌,对抗生素的耐药率依次为环丙沙星(100. 00%)、青霉素(73. 02%)、四环素(65. 08%)、阿奇霉素(21. 43%),检出17. 46%(22/126)的阿奇霉素高水平耐药(AZ-HLR)(MIC≥256mg/L)菌株,未发现耐大观霉素、头孢曲松、头孢克肟的淋球菌。57. 14%(72/126)的菌株为PPNG。NG-MAST分型结果显示,126株淋球菌分为82种不同的STs型别,其中ST1866(6. 35%)、ST1927(5. 56%)、ST3102(5. 56%)是主要ST型,没有明显优势的ST型别。结论本地区分离的淋球菌存在遗传背景的多样性;阿奇霉素耐药性较高,且发现AZ-HLR菌株,不适合单独治疗淋球菌感染;头孢曲松和大观霉素仍可作为淋病抗感染的一线药物。Objective To investigate the antibiotic resistance and molecular epidemiology of clinically isolated Neisseria gonorrhoeae( NG). Methods A total of 126 NG strains were collected from 2015 to 2016 in Xiaoshan district,Hangzhou. Minimum inhibitory concentrations( MIC) to penicillin,tetracycline,spectinomycin,ciprofloxacin,ceftriaxone,cefixime and azithromycin were determined by the agar dilution method. Cefalotin paper discs were used for detection of penicillinase-producing NG( PPNG). ST of the strain was determined by Neisseria gonorrhoeae multi-antigen sequence typing( NGMAST). Results Of the 126 NG strains,100. 00% displayed resistance to ciprofloxacin,73. 02% to penicillin,65. 08% to tetracycline,and 21. 43% to azithromycin. In addition,17. 46% of isolates were azithromycin high-level resistance( AZ-HLR). No resistant strain was found for spectinomycin,ceftriaxone and cefixime. 57. 14%( 72/126) of isolates were identified as PPNG. NG MAST analysis showed all of isolates were divided into 82 different STs types,of which ST1866( 6. 35%),ST1927( 5. 56%),and ST3102( 5. 56%) were the main ST types,and there was no obviously prevalent ST. Conclusion There was a diversity of genetic background in NGs from local population. The resistance rate of azithromycin was high and AZ-HLR isolates were found. Therefore,azithromycin is not preferable for the treatment of NG infection alone. Ceftriaxone and spectinomycin can still be used as the rst-line therapy against gonorrhoea.

关 键 词：淋病奈瑟菌 感染 耐药性 NG-MAST 

分 类 号：R759.2[医药卫生—皮肤病学与性病学]