2018—2022年438株淋球菌临床分离株耐药性分析  

Analysis of antibiotic resistance of 438 clinical isolates of Neisseria gonorrhoeae obtained from 2018 to 2022

作　　者：梁焕喜 劳丽嫦 黎敬忠 何晓能 黄蕴怡 郭键瑜 郭炽星 LIANG Huanxi;LAO Lichang;LI Jingzhong;HE Xiaoneng;HUANG Yunyi;GUO Jianyu;GUO Chixing(Panyu Institute of Chronic Disease;Panyu Blood Bank,3.Guangzhou Panyu Health Management Center;Guangzhou Panyu Rehabilitation Hospital,Guangzhou 511400,China)

机构地区：[1]广州市番禺区慢性病防治站 [2]广州市番禺区中心血站 [3]广州市番禺区健康管理中心广州市番禺区康复医院,广东广州511400

出　　处：《皮肤性病诊疗学杂志》2024年第7期464-469,共6页Journal of Diagnosis and Therapy on Dermato-venereology

基　　金：番禺区科技计划项目(2021-Z04-107)。

摘　　要：目的 总结青霉素、四环素、环丙沙星、头孢克肟、头孢曲松、大观霉素和阿奇霉素等7种抗生素的耐药性监测结果,分析番禺区淋球菌耐药株的流行状况。方法 2018—2022年间收集番禺区性病门诊患者尿道或宫颈、阴道等泌尿生殖道分泌物中分离得到的淋球菌菌株,采用琼脂稀释法测定菌株对7种抗生素的最小抑菌浓度(MIC),用纸片酸度法检测产青霉素酶淋球菌(PPNG),比较各年度的淋球菌菌株对抗生素敏感性和流行率。结果 共收集并检测了438株淋球菌,其中PPNG和四环素高水平耐药淋球菌(TRNG)流行率分别为48.86%和38.13%。四环素、环丙沙星、阿奇霉素的总耐药率分别为90.18%、96.12%和13.47%,青霉素的耐药率从2018年的50.60%升高至2022年的84.00%,差异有统计学意义(χ~2=23.59,P<0.01),未发现大观霉素、头孢曲松和头孢克肟耐药菌株。但头孢曲松和头孢克肟中敏菌株分别由2018年的2.41%(2/83)和3.61%(3/83)上升至2022年的13.00%(13/100)和25.00%(25/100),差异均有统计学意义(χ~2值分别为6.76、14.39,均P<0.01),呈动态升高趋势。结论 2018—2022年番禺区淋球菌菌株对大观霉素、头孢曲松和头孢克肟均敏感,头孢曲松和头孢克肟中度敏感率呈逐年升高态势,PPNG和TRNG也呈高度流行状态。Objective To summarize the surveillance results of antibiotic resistance of Neisseria gonorrhoeae to 7 antibiotics(penicillin G,tetracycline,ciprofloxacin,spectinomycin,cefixime,ceftriaxone and Azithromycin)in Panyu District,Guangzhou,from 2018 to 2022.Methods Neisseria gonorrhoeae strains were isolated from urogenital secretions such as urethra or cervical vagina at the sexually transmitted disease outpatient clinic of Panyu District from 2018 to 2022.The agar dilution method was used to determine the minimum inhibitory concentrations(MICs)of the seven antibiotics.Penicillinase-producing N.gonorrhoeae(PPNG)was analyzed by the paper acidometric method.The sensitivity and prevalence of Neisseria gonorrhoeae strains to antibiotics were compared among those years.Results A total of 438 strains of Neisseria gonorrhoeae were collected.Among them,the rates of PPNG and TRNG were 48.86%(214/438)and 38.13%(167/438),respectively.The overall resistance rates to tetracycline,ciprofloxacin,and azithromycin were 90.18%,96.12%,and 13.47%,respectively.The resistance rate to penicillin was increased significantly from 50.60%in 2018 to 84.00%in 2022(2=23.59,P<0.01).We found no strains resistant to spectinomycin,ceftriaxone,and cefixime.However,the intermediate sensitivity to ceftriaxone and cefixime was increased from 2.41%(2/83)and 3.61%(3/83)in 2018 to 13.00%(13/100)and 25.00%(25/100)respectively,in 2022(2=6.76,P<0.01 and 2=14.39,P<0.01).Conclusions All Neisseria gonorrhoeae strains collected from 2018 to 2022 are sensitive to erythromycin,ceftriaxone,and cefixime.However,there is a trend of yearly increase in the rates of low-sensitivity to ceftriaxone and cefixime,and PPNG and TRNG are also highly prevalent.

关 键 词：淋病 奈瑟氏球菌 药物监测 微生物敏感性试验 耐药性分析 

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