中国1993～2000年分离淋球菌的流行病学和细菌学特征  

Epidemiological and bacteriological characteristics of Neisseria gonorrhoeae isolates in China

作　　者：叶顺章[1] 王千秋[1] 苏晓红[1] 尹跃平[1] 戴秀芹[1] 孙厚华[1] 

机构地区：[1]中国医学科学院中国协和医科大学皮肤病研究所全国性病麻风病控制中心,南京210042

出　　处：《中华流行病学杂志》2003年第2期119-122,共4页Chinese Journal of Epidemiology

基　　金：WHO西太区办公室资助项目 (I .D .LAB/CHN/97/0 1)

摘　　要：目的　研究中国 1 993～ 2 0 0 0年分离的淋球菌对青霉素、四环素、环丙沙星、大观霉素和头孢曲松的敏感性及其营养分型和携带质粒情况 ,为制订淋病治疗方案和防治对策的参考依据。方法　用琼脂稀释法测定菌株对抗菌药物的敏感性 ,用改良Catline法和碱裂解法测定菌株的营养分型和携带耐药质粒的情况。结果　 8年来共检测了 4 976株淋球菌对抗生素的敏感性 ,发现对青霉素耐药率为 71 .60 % ,产青霉素酶淋球菌 (PPNG)菌株占 1 5 .54 % ;对四环素的耐药菌株占 93 .0 2 % ,由质粒介导的高度耐四环素淋球菌 (TRNG)菌株占 1 0 .48% ;环丙沙星的耐药菌株占 53 .30 % ;对大观霉素和头孢曲松的耐药菌株分别占 0 .36 %和 0 .46 %。 1 995年和 1 996年南京地区菌株的营养分型原型(proto)占46 .4 %和 47.53 % ,脯氨酸 (pro- )型占 48.4 %和 50 .2 2 %。对 40株淋球菌作了质粒分型 :30株非PPNG菌株中 ,2株 (1 5 % )不含任何质粒 ;2 8株含有 4 .2kb、4 .9kb、5 .4kb和 39.5kb质粒 ;1 0株PPNG菌株中 ,8株含 4 .2kb、5 .4kb和 39.5kb质粒 ;2株除上述三种质粒外 ,尚含有 4 .9kb质粒。PPNG株和非PPNG株所含有的 5 .4kb质粒虽分子量相近 ,但酶切点不尽相同。结论　 1 993～ 2 0 0 0年分离的淋球菌对青霉素、四环素和环丙沙?Objective To investigate the antimicrobial susceptibility,auxotype, and plasmid profile of Neisseria gonorrhoeae isolates in China and to provide evidence for the development of treatment guideline and policy for control. Methods Agar dilution was used to detect antimicrobial susceptibility. The auxotype was determined by GC genetic medium. The plasmid was extracted by aklaline cleavage and electrophresed. Results A total of 4 976 gonococcal isolates were tested in the last 8 years. The resistant rate for penicillin was 71.60 % with PPNG being 15.54 %. Tetracycline resistant (TRNG) isolates accounted for 93.02 % with 10.48 % high level tetracycline resistant. The resistant rate for ciprofloxacin was also relatively high ( 31.78 %). The resistant rates for spectinomycin and ceftriaxone were 0.36 % and 0.46 %. The predominant auxotypes of gonococcal isolates were proto and pro - during 1995 1996 in Nanjing,accounted for 46.4 % and 47.53 %, 48.4 % and 50.22 %, respectively. There were 8 strains harboring 4.2 , 5.4 , 39.5 kb plasmids and 2 harboring 4.2 , 4.9 , 5.4 , 39.5 kb plasmids in 10 PPNG strains; 2 harboring no pasmid, 28 harboring 4.2 , 4.9 , 5.4 , 39.5 kb plasmids in 30 non PPNG strains. The 5.4 kb plasmid of PPNG could be digested with restriction endonuclease BamHI while the 5.4 kb plasmid of non PPNG could not. Conclusion The gonococcal isolates were highly resistant to penicillin, tetracycline, and ciprofloxacin, while were still sensitive to spectinomycin and ceftriaxone. No significant auxotyping change was found in terms of predominant gonococcal strains in the last two years in Nanjing while 5.4kb plasmid might be the most prevalent resistant plasmid in Nanjing.

关 键 词：中国 1993-2000年 分离 淋球菌 流行病学 细菌学 

分 类 号：R181.3[医药卫生—流行病学]