广西地区淋球菌临床分离株对庆大霉素的药物敏感性研究  

Susceptibility of gonococcal clinical isolates to gentamicin in Guangxi region

作　　者：朱邦勇 周潜 韦江平 甘泉 黄寅杰 尹跃平 徐文绮 Zhu Bangyong;Zhou Qian;Wei Jiangping;Gan Quan;Huang Yinjie;Yin Yueping;Xu Wenqi(Central Laboratory,Dermatology Institute of Guangxi Zhuang Autonomous Region,Nanning 530007,China;Reference Laboratory of STD,Hospital of Dermatology,Chinese Academy of Medical Sciences and Peking Union Medical College,Nanjing 210042,China)

机构地区：[1]广西壮族自治区皮肤病防治研究所中心实验室,南宁530007 [2]中国医学科学院北京协和医学院皮肤病医院性病参比实验室,南京210042

出　　处：《中华皮肤科杂志》2023年第8期737-741,共5页Chinese Journal of Dermatology

基　　金：“艾滋病和病毒性肝炎等重大传染病防治”科技重大专项基金(2018ZX10101001-004-003)。

摘　　要：目的评估中国广西地区淋球菌临床分离株对庆大霉素的药物敏感性以及庆大霉素与其他7种抗生素最小抑菌浓度(MIC)之间的相关性。方法2020年12月至2021年12月在广西地区14个地级市的37家医疗机构收集淋球菌临床分离株584株,采用琼脂稀释法测定淋球菌对头孢曲松、头孢克肟、阿奇霉素、大观霉素、青霉素、四环素、环丙沙星和庆大霉素的药物敏感性。将各抗生素MIC值进行以2为底数的对数转换,采用Spearman相关性分析评估庆大霉素MIC与其他7种抗生素MIC之间的相关性。结果庆大霉素的MIC范围为1~16 mg/L,MIC_(50)及MIC_(90)值分别为4、8 mg/L;361株(61.8%)庆大霉素MIC≤4 mg/L,为完全敏感菌株,223株(38.2%)MIC为8~16 mg/L,为中度敏感株,未见耐药株。淋球菌对阿奇霉素、青霉素、四环素、环丙沙星的耐药菌株数分别为136(23.3%)、415(71.1%)、339(58.0%)和574(98.3%),对头孢曲松和头孢克肟的低敏菌株数分别为17(2.9%)和6(1.0%),未发现对大观霉素耐药的菌株。Spearman相关分析显示,庆大霉素MIC与阿奇霉素、大观霉素、青霉素、四环素、环丙沙星MIC弱相关(均P<0.05),与头孢曲松、头孢克肟MIC之间无相关性(均P>0.05)。结论本研究中测试的所有淋球菌分离株均对庆大霉素表现出一定程度的敏感性,庆大霉素与其他抗生素之间存在交叉耐药性的可能性较小。Objective To assess the susceptibility of gonococcal clinical isolates to gentamicin in Guangxi region,China,and to analyze the correlation between the minimum inhibitory concentration(MIC)of gentamicin and MICs of 7 other antibiotics.Methods From December 2020 to December 2021,584 gonococcal clinical isolates were collected from 37 medical institutions in 14 prefecture-level cities in Guangxi region.The susceptibility of gonococcal clinical isolates to ceftriaxone,cefixime,azithromycin,spectinomycin,penicillin,tetracycline,ciprofloxacin and gentamicin was determined by using an agar dilution method.The MIC values of antibiotics were logarithmically transformed with base 2,and Spearman correlation analysis was carried out to evaluate the correlation between the MIC of gentamicin and MICs of the other 7 antibiotics.Results The MIC of gentamicin ranged from 1 to 16 mg/L,and the MIC_(50) and MIC_(90) values were 4 and 8 mg/L,respectively;361 strains(61.8%)were fully sensitive to gentamicin with the MIC≤4 mg/L,223 strains(38.2%)moderately sensitive with the MIC ranging from 8 to 16 mg/L,and no gentamicin-resistant strains were found.The number of strains resistant to azithromycin,penicillin,tetracycline and ciprofloxacin was 136(23.3%),415(71.1%),339(58.0%)and 574(98.3%)respectively,the number of lowly sensitive strains to ceftriaxone and cefixime was 17(2.9%)and 6(1.0%)respectively,and no spectinomycin-resistant strains were found.Spearman correlation analysis showed that the MIC of gentamicin was weakly correlated with the MICs of azithromycin,spectinomycin,penicillin,tetracycline,and ciprofloxacin(all P<0.05),but was uncorrelated with the MICs of ceftriaxone and cefixime(both P>0.05).Conclusion All gonococcal clinical isolates tested in this study showed a certain degree of susceptibility to gentamicin,and cross-resistance between gentamicin and other antibiotics was less likely to occur.

关 键 词：淋病奈瑟球菌 庆大霉素类 青霉素类 微生物敏感性试验 最小抑菌浓度 

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]