587株淋球菌对青霉素等7种抗生素耐药观察  

Analysis of antimicrobial resistance to 7 antimicrobial agents in 587 strains of Neisseria gonorrhoeae

作　　者：李明 邹裕 黄文丽 周湧 郭文婷 黄少隆 LI Ming;ZOU Yu;HUANG Wen-li;ZHOU Yong;GUO Wen-ting;HUANG Shao-long(Department of Clinical Laboratory,The Fifth People’s Hospital,Dongguan 523907,China)

机构地区：[1]东莞市第五人民医院检验科

出　　处：《皮肤性病诊疗学杂志》2019年第4期210-214,共5页Journal of Diagnosis and Therapy on Dermato-venereology

基　　金：广东省东莞市科技局项目(编号:201750715025152);广东省淋球菌耐药监测项目资助

摘　　要：目的:对2016-2018年我院分离的587株淋球菌对青霉素等7种抗生素的耐药性监测结果进行分析,了解本地区淋球菌的耐药状况。方法:对2016年1月-2018年12月分离的587株淋球菌,采用微量肉汤稀释法测定对青霉素、环丙沙星、四环素、大观霉素、阿奇霉素、头孢克肟和头孢曲松的最低抑菌浓度(MIC),并采用纸片酸度法测定产β-内酰胺酶淋球菌(PPNG)菌株,判断标准按WHO西太区淋球菌耐药性监测统一标准。结果:587株淋球菌中,共检出PPNG 226株,占38.5%(226/587);TRNG 218株,占37.1%(218/587)。三年间PPNG(2=3.51,P>0.05)和TRNG(2=3.26,P>0.05)的流行率均无统计学差异。青霉素、环丙沙星、四环素、阿奇霉素的耐药率分别为73.8%、99.7%、95.6%、17.9%,未发现头孢曲松、头孢克肟和大观霉素耐药株,但头孢曲松和头孢克肟的低敏率分别为6.5%和9.9%。结论:587株淋球菌对青霉素、环丙沙星、四环素耐药状况严重,但对头孢曲松、头孢克肟、大观霉素敏感性较高。对淋球菌进行持续耐药监测,有助于了解流行菌株的耐药情况,为临床经验用药和合理用药提供依据。Objective:To investigate the antimicrobial resistance to 7 antimicrobial agents of clinical isolates of Neisseria gonorrhoeae in our hospital from 2016 to 2018. Methods: A total of 587 Neisseria gonorrhoeae were isolated during January 2016 to December 2018.Minimal inhibitory concentrations(MIC) of Penicillin,Tetracycline,Ciprofloxacin,Spectinomycin,Cefixime,Ceftriaxone,Azithromycin were determined by the micro broth dilution method, penicillinase-producing Neisseria gonorrhoeae(PPNG) was detected by the paper acidometric testing. The resistance of all strains was interpreted according to criteria used in the project of surveillance of gonococcal antibiotic susceptibility in the WHO Western Pacific Region. Results: Of the 587 Neisseria gonorrhoeae, penicillinase-producing Neisseria gonorrhoeae(PPNG) accounted for 38.5%(226/587),plasmid-mediated Tetracycline-Resistant Neisseria gonorrhoeae(TRNG) accounted for 37.1%(218/587).There were no significant difference about PPNG(χ^2=3.51,P>0.05)and TRNG(χ^2=3.26,P>0.05)prevalence rate in three years. The prevalence of Penicillin, Ciprofloxacin, Tetracycline and Azithromycin-resistance was accounted for 73.8%, 99.7%, 95.6%, 17.9%,respectively. No Neisseria gonorrhoeae was found resistant to Ceftriaxone, Cefixime and Spectinomycin, but 6.5%(38/587)and 9.9%(58/587) showed reduced sensitivity to Ceftriaxone and Cefixime. Conclusions: A total of 587 Neisseria gonorrhoeae strains are highly resistant to Penicillin, Ciprofloxacin and Tetracycline, while sensitive to Ceftriaxone, Cefixime and Spectinomycin. Continuous surveillance of drug resistance of Neisseria gonorrhoeae is most important and valuable in understanding the trend of antimicrobial resistance and rational antimicrobial therapy.

关 键 词：淋病奈瑟氏菌 最低抑菌浓度 PPNG TRNG 耐药监测 

分 类 号：R759.2[医药卫生—皮肤病学与性病学]