2018~2020年昆明市淋球菌耐药监测结果分析  

Surveillance results of the antimicrobial resistance of Neisseria gonorrhoeae isolates in Kunming from 2018 to 2020

作　　者：曾志君 杨敏 郭明天 卢赞[3] 董桂琼 陈会超[1] 孙鹏艳 陈敏[1] 杨莉[1] ZENG Zhijun;YANG Min;GUO Mingtian;LU Zan;DONG Guiqiong;CHEN Huichao;SUN Pengyan;CHEN Min;YANG Li(Institute for AIDS/STDs Control and Prevention,Yunnan Center for Disease Control and Prevention,Kunming 650022,China;Institute of Medical Biology,Chinese Academy of Medicine Science,Kunming,650118,China;Department of Clinical Laboratory,The First Hospital of Kunming,Kunming,650224,China;Guandu District People's Hospital of Kunming City,Kunming,650118,China)

机构地区：[1]云南省疾病预防控制中心性病艾滋病防制所,云南昆明650022 [2]中国医学科学院医学生物学研究所,云南昆明650118 [3]昆明市第一人民医院检验科,云南昆明650011 [4]昆明市官渡区人民医院,云南昆明650220

出　　处：《皮肤病与性病》2022年第4期285-289,共5页Dermatology and Venereology

基　　金：国家科技重大专项(2018ZX10715-006)。

摘　　要：目的 了解2018~2020年在云南省昆明市收集的422株淋球菌对7种抗生素的敏感性,为临床治疗提供依据。方法 用琼脂稀释法测定淋球菌对青霉素、环丙沙星、阿奇霉素、头孢曲松、头孢克肟、大观霉素、四环素的最低抑菌浓度(MIC),采用纸片酸度法测定产β-内酰胺酶淋球菌(PPNG)。结果 422株淋球菌中,检出PPNG 282株(66.82%),质粒介导的高度耐四环素淋球菌(TRNG)181株(42.89%);环丙沙星、四环素、青霉素、阿奇霉素耐药率分别为99.76%(421/422)、89.81%(379/422)、73.70%(311/422)、10.09%(46/422);对头孢曲松和头孢克肟敏感性降低(低敏)的菌株分别占5.21%(22/422)和6.64%(28/422);未发现对大观霉素耐药的菌株。发现6株(1.42%)对阿奇霉素耐药且同时对头孢曲松低敏的菌株。结论 昆明市淋球菌对大观霉素、头孢曲松和头孢克肟的敏感性较好,可作为首选治疗药物,应持续对本地区淋球菌耐药变化趋势进行监测。Objective To investigate the antimicrobial susceptibility to 7 antimicrobial agents of 422 Neisseria gonorrhoeae isolates collected in Kunming,Yunnan province from 2018 to 2020 and to provide basis for clinical treatment of gonorrhea. Methods Minimum inhibitory concentrations(MICs) of penicillin,ciprofloxacin,azithromycin,ceftriaxone,cefixime,spectinomycin and tetracycline were determined by agar dilution method,and β-lactamase-producing Neisseria gonorrhoeae(PPNG) isolates were detected by the paper acidimetric method. Results Among the 422 isolates,282(66.82%) were PPNG and 181(42.89%)were Plasmid-mediated Tetracycline-resistant Neisseria gonorrhoeae(TRNG). The rates of resistance to ciprofloxacin,tetracycline,penicillin,and azithromycin were 99.76%(421/422),89.81%(379/422),73.70%(311/422) and 10.09%(46/422) respectively. 5.04%(22/422) of the isolates showed decreased susceptibility to ceftriaxone and 6.42%(28/422) showed decreased susceptibility to cefixime. No isolates that resistant to spectinomycin was observed. In addition,6(1.42%) strains were simultaneously showed decreased susceptibility to Ceftriaxone and resistant to azithromycin.Conclusion Spectinomycin,ceftriaxone and cefixime can be chosen as the premier therapeutics due to the higher susceptibility in Kunming. In addition,continuous surveillance of drug resistance of Neisseria gonorrhoeae is essential for local area.

关 键 词：淋球菌 耐药 监测 最低抑菌浓度 多重耐药 

分 类 号：R446.5[医药卫生—诊断学] R759.2[医药卫生—临床医学]