南昌地区淋球菌对抗生素的耐药性及质粒谱分析

Analysis on antibiotic resistance and plasmid profiles of Neisseria gonorrhoeae in Nanchang area

目的了解南昌地区淋病患者感染的淋球菌对抗生素的耐药状况,探讨质粒在介导淋球菌耐药中的作用。方法采用纸片法分析69株淋球菌对头孢噻肟,头孢曲松、头孢他啶、青霉素、壮观霉素、环丙沙星的敏感性;头孢硝基噻吩显色法测定β-内酰胺酶;碱裂解法提取淋球菌菌株质粒,琼脂糖凝胶电泳法分析质粒谱型。结果对青霉素、环丙沙星、壮观霉素耐药的菌株分别为39株(39/69,56.52%)、67株(67/69,97.10%)、1株(1/69,1.45%),头孢噻肟,头孢曲松,头孢他啶未发现耐药株。β-内酰胺酶阳性菌株为35株(35/69,50.72%)。检出质粒菌株37株(37/69,53.62%),质粒谱型共5型,以39.5 Kb和39.5 Kb+42.5 Kb型为主。结论青霉素、环丙沙星的耐药率较高,在本地区已不适宜作为治疗淋病的药物,头孢噻肟,头孢曲松,头孢他啶的敏感性较高,可作为本地区治疗淋病的首选药物,壮观霉素已出现耐药株应引起重视。质粒的介导在淋球菌耐药性的形成中起着重要的作用。

Objective To survey the antibiotic resistance and the role of plasmid-on mediating resistance of Neisseria gonorrhoeae（N.gonrrhoeae） in Nanchang area.Methods The disk diffusion method was used to determine the resistance of six antibiotics including cefotaxime,ceftriaxone,ceftazidime,penicillin,spectinomycin and ciprofloxacin to N.gonrrhoeae.Penicillinase-producing N.gonrrhoeae（PPNG） was determined by using the Nitrocefin-disk method.Extraction and analysis of the plasmids in 69 N.gonorrhoeae were determined by alkaline-lysis and sepharose electrophoresis technic.Results The strains of 39（39/69,56.52%）,67（67/69,97.10%） and 1（1/69,1.45%） were found to be resistant to penicillin,ciprofloxacin and spectinomycin,respectively.No strains were found to be resistant to cefotaxime,ceftriaxone,ceftazidime.There were 35（50.72%） strains of PPNG among 69 N.gonorrhoeae.37 strains of N.gonrrhoeae harbourde plasmids and the detected percentage accounting for 53.62%.A total of five types of plasmids were detected.The plasmid profiles types of 39.5 Kb（24.63%） and 39.5 Kb＋42.5 Kb（13.04%） were prominent.Conclusion Resistance rate of penicillin and ciprofloxacin is higher than others.In Nanchang region,penicillin and ciprofloxacin have been inappropriate as a treatment for gonorrhea drug.Susceptibility of cefotaxime,ceftriaxone,ceftazidime is high and can be used as the first chice for treatment of gonorrhea drugs in this region.Clinical doctors need to pay more attention to spectinomycin because resistant strain has been detected.Plasmid plays an important role in formation of resistance in Neisseria gonorrhoeae.