淋菌对β-内酰胺类抗菌药物的药敏试验结果回顾性分析

Drug susceptibility tests of neisseria gonorrhoeae to β-lactams antibiotics:a retrospective analysis

目的了解淋菌对β-内酰胺类抗菌药物的敏感性,为淋病的防治提供科学依据。方法回顾性分析纸片扩散法检测86株淋菌对6种β-内酰胺类抗菌药物的药敏试验结果,产色头孢硝噻吩法检测β-内酰胺酶。结果质粒介导的产青霉素酶淋菌阳性菌株30株,占34.88%;淋菌对青霉素、头孢呋辛、头孢噻肟、头孢他啶、头孢曲松、头孢吡肟的敏感率分别为8.14%、75.58%、90.70%、93.02%、86.05%、94.19%;青霉素的药物敏感性显著低于头孢呋辛,差异有统计学意义(χ2=80.36,P<0.01);头孢呋辛的药物敏感性比头孢曲松的药物敏感性低,差异无统计学意义,但是头孢呋辛有5株耐药菌株;头孢噻肟、头孢他啶、头孢曲松、头孢吡肟的敏感率,差异无统计学意义。结论第三、四代头孢菌素可作为治疗淋菌感染的一线药物。

OBJECTIVE To investigate the β-lactams susceptibility of Neisseria gonorrhoeae and provide scientific basis for the treatment and prevention of gonorrhea.METHODS A retrospective survey was conducted.β-lactams susceptibility tests were tested by Disk diffusion,and β-lactamase was determined by nitrocefin.RESULTS Plasmid mediated penicillinase producing Neisseria gonorrhoeae（PPNG） were 30 straines（34.88 %）.Susceptive rates of penicillin,cefuroxime,cefotaxime,ceftazidime,ceftriaxone and cefepime were 8.14%,75.58%,90.70%,93.02%,86.05% and 94.19%,respectively.The sensitivity of penicillin was lower than that of cefuroxime with significant difference（χ2=80.36,P0.001）.The sensitivity of cefuroxime was lower than that of ceftriaxone without significant difference（χ2=3.04,P=0.08）,while there were 5 resistant strains for cefuroxine.There was no significant difference（χ2=4.08,P=2.53） among the sensitivities of cefotaxime,ceftazidime,ceftriaxone and cefepime.CONCLUSION The third generation of cephalosporins such as cefotaxime,ceftazidime,ceftriaxone and the forth generation of cephalosporins such as cefepime can be selected as the first line antibiotics against the neisseria gonorrhoeae infection.