2015—2018年广州地区淋球菌耐药性结果分析  

Drug-resistance of neisseria gonorrhoeae strains in Guangzhou during 2015-2018

作　　者：黎小东[1] 梁景耀[1] 曹文苓[1] 毕超[1] 李平[1] 梁艳华[1] 张锡宝[1] Li Xiaodong;Liang Jingyao;Cao Wenling;Bi Chao;Li Ping;Liang Yanhua;Zhang Xibao(Department of Clinical Laboratory,Guangzhou Institute of Dermatology,Guangzhou 510095,China)

机构地区：[1]广州市皮肤病防治所检验科,510095

出　　处：《国际医药卫生导报》2020年第12期1665-1668,共4页International Medicine and Health Guidance News

基　　金：广东省自然科学基金项目(2018A0303130011);广东省医学科学技术研究基金项目(2017239);广州市医药卫生科技项目(20171A011284)。

摘　　要：目的监测2015—2018年广州地区淋球菌分离菌株对7种抗生素的耐药情况及β-内酰胺酶阳性菌株(PPNG)、质粒介导的高度耐四环素淋球菌(TRNG)的流行趋势。方法收集本单位门诊分离培养的淋球菌437株,通过纸片碘量法测定β-内酰胺酶,琼脂稀释法测定青霉素、环丙沙星、大观霉素、头孢曲松、头孢克肟、阿奇霉素和四环素的最小抑菌浓度(MIC)。结果测出PPNG与TRNG分别为32.7%(143/437)和28.8%(126/437),PPNG呈上升趋势,TRNG呈下降趋势;环丙沙星和青霉素耐药率高达98.0%(428/437)和85.1%(372/437),阿奇霉素耐药率达13.3%(58/437),未发现大观霉素的耐药菌株,头孢曲松和头孢克肟低敏率波动大:7.1%~25.0%和9.2%~33.0%。结论头孢菌素类和大观霉素仍可作为广州地区淋病治疗的首选药物;为科学地制定合理抗菌治疗方案提供实验室依据,应持续进行淋球菌耐药性监测。Objective To evaluate the resistance of clinically isolated neisseria gonorrhoeae(NG)to 7 antibiotics and the trends of penicillinase-producing neisseria gonorrhoeae(PPNG)and tetracycline resistant neisseria gonorrhoeae(TRNG)in patients with gonorrhea who presented to STD clinic in Guangzhou during 2015-2018.Methods 437 NG isolates were collected from the patients’urethra or cervix uteri.Theβ-lactamase was detected by paper acidmetric testing.The minimum inhibitory concentrations(MICs)of penicillin(P),ciprofloxacin(CIP),sepctinomycin(SPT),ceftriaxone(CRO),cefixine(CTX),azithromycin(AZI),and tetracycline(TE)were determined by agar dilution.Results A Total of 437 NG isolates were collected from the patients with gonorrhea.The PPNG and TRNG strains accounted for 32.7%(143/437)and 28.8%(126/437).The positive rate of PPNG isolates increased,but that to TRNG isolates decreased.Among those isolates,the resistance rates of CIP and P were 98.0%(428/437)and 85.1%(372),respectively,that of AZI 13.3%(58/437),and no isolate was resistant to SPT.The mordrate sensitivities to CRO and CTX were in large volatility:7.1%-25.0%and 9.2%-33.0%.Conclusion CRO,CTX,and SPT are still preferable as first choices for gonorrhea in Guangzhou,suggesting that it is essential to continuously monitor antimicrobial resistance of Neisseria gonorrhoeae,so as to provide scientific guidance for formulating a reasonable antimicrobial treatment plan.

关 键 词：淋球菌 最小抑菌浓度 TRNG PPNG 

分 类 号：R759.2[医药卫生—皮肤病学与性病学] R446.5[医药卫生—临床医学]