中国淋球菌头孢菌素类药物临床耐药监测方案的推进现状调查  

The results of promotion on Chinese clinical-based surveillance of the resistance Neisseria gonorrhoeae to cephalosporins proposal

作　　者：韩燕[1] 尹跃平[1] 曹文苓[2] 朱邦勇 郑钟洁[4] 吴兴中 唐小正 张保原[7] 陈绍椿[1] 戴秀芹[1] 陈祥生[1] 

机构地区：[1]中国医学科学院北京协和医学院皮肤病医院,中国疾病预防控制中心性病控制中心,南京210042 [2]广州市皮肤病防治所,广州510095 [3]广西壮族自治区皮肤病防治研究所,南宁530003 [4]天津市疾病预防控制中心,天津300040 [5]广东省皮肤病医院,广州510310 [6]海南省皮肤病医院,海口570100 [7]江门市皮肤医院,广东江门529000

出　　处：《中国艾滋病性病》2015年第2期146-148,156,共4页Chinese Journal of Aids & STD

摘　　要：目的为了更好地推进《中国淋球菌头孢菌素类药物临床耐药监测方案》,发现实施过程中的问题。方法在6个签署《中国淋球菌头孢菌素临床耐药监测工作协议书》的监测点,经方便抽样,招募并随访成功191例无并发症的淋病患者,采用统一的调查表对淋病患者进行调查,并对患者的标本进行淋球菌药敏纸片扩散（K-B）法的测定。结果 191例无并发症的淋病患者中,56例患者自述曾经患有性传播疾病,95.8%的患者以分泌物异常就诊。其中150例患者利用头孢曲松钠治疗,剂量为1000~7000mg不等。淋球菌药敏纸片扩散法结果显示,90.0%的菌株对头孢曲松钠敏感,85.9%菌株对头孢克肟敏感。结论在推进《中国淋球菌头孢菌素类药物临床耐药监测方案》的过程中,存在一些问题：1）临床医生用药的剂量差别较大;2）采用K-B法作为监测药物的敏感性还有待进一步的探讨;3）应增加相关性传播疾病的筛查及相关药物的调查。Objective In order to better promote Chinese clinical-based surveillance of the resistance of Neisseria gonorrhoeae to cephalosporins proposal and to find the problems in the process of implementation.MethodsFrom 2010 July to December,a total of 191 patients with gonorrhea were recruited and underwent a follow-up visit by convenience sampling from six surveillance sites which signed cooperation agreements on China clinical-based surveillance of the resistance Neisseria gonorrhoeae.Demographic information and the situation of antibiotics application were collected anonymously by a uniform questionnaire.The sensitivity tests of strains from clinically-isolated bacteria to ceftriaxone and cefixime were determined by K-B program.Results Among 191 patients,56patients had suffered from sexually transmitted disease,95.8% patients had abnormal secretions,and 150 of them had been treated with ceftriaxone with the doses of ranges from 1000 mg to 7000 mg.90% of the isolates were sensitive to ceftriaxone and 85.9% were sensitive to cefixime.Conclusions There are some problems in the process of implementing this proposal：1.Dosage differences existed in the antibiotic therapeutic schedule;2.The usage of the K-B program for surveillance of drug sensitivity is non-suitable;3.Need to add the screening for other sexually transmitted diseases and the drug usage.

关 键 词：淋球菌 头孢菌素 临床耐药监测 

分 类 号：R759.2[医药卫生—皮肤病学与性病学]