淋球菌临床分离株药敏分析

Analysis of susceptibility test in Neisseria gonorrhoeae clinical isolates

目的明确本院淋球菌的耐药情况及产青霉素酶的淋球菌（PPNG）和质粒介导的耐四环素淋球菌（TRNG）流行现状，为临床防治方案的制定提供依据。方法运用VITEK2 Compact全自动微生物鉴定仪对2014年1月至2015年12月本院临床分离菌株进行菌种鉴定，采用琼脂微稀释法测定青霉素、四环素、环丙沙星、头孢曲松和大观霉素5种抗菌药物对淋球菌进行药敏实验，用纸片酸度定量法测定淋球菌株的β-内酰胺酶。结果183株受试淋球菌中检出PPNG57株（31．1％），质粒介导的TRNG59株（32．2％）；青霉素、四环素、环丙沙星耐药率分别为91．8％、75．4％和97．3％；未检出头孢曲松耐药菌株，低敏菌株检出率为11．5％；未检出大观霉素耐药及低敏菌株；青霉素、四环素和环丙沙星50％最低抑菌浓度（MIC50）及90％最低抑菌浓度（MIC90）值均已超过耐药标准；淋球菌多重耐药菌株检出率为91．8％（168／183）。结论佛山地区淋球菌临床分离株对青霉素和环丙沙星呈现高耐药率，多重耐药现状严峻。

Objective To investigate drug resistance of Neisseria gonorrhoeae and the prevalence of penicillinase-producing Neisseria gonorrhoeae （PPNG） and tetracycline-resistant Neisseria gonorrhoeae （TRNG） in Hospital so as to provide evidence for clinical prevention and treatment programs . Methods Species identification of clinical isolates from January 2014 to December 2015 was performed using VITEK2 instrument. The drug susceptibility for Neisseria gonorrhoeae to 5 antibiotics （penicillin , tetracycline, ciprofloxacin, ceftriaxone and spectinomycin） were determined by agar dilution method and 13 -lactamase was measured by paper acidometric method. Results 57 strains were PPNG （31.1%） and 59 strains were TRNG （32.2%） among 183 strains . The rates of resistance to penicillin, tetracycline and ciprofloxacin were 91.8%, 75.4% and 97.3%, respectively. Ceftriaxone resistant strain was no detected, the rate of low susceptibility to ceftriaxone was 11.5% . Spectinomycin resistant strain and its low susceptibility were no detected. MICs0 and MICg0 of penicillin, tetracycline and eiprofloxacin have exceeded the drug resistance standards. The rate for MDR was 91.8% （168/183）. Conclusions Neisseria gonorrhoeae showed high level of durg resistance to penicilin and ciprofloxacin and significantly high detection rate of MDR phenotype in Foshan.