山东地区淋病奈瑟菌临床菌株常用抗生素的耐药性分析

Analysis of antimicrobial resistance in Neisseria gonorrhoeae isolated from Shandong against six antimicrobial agents

目的对2014年6月—2016年6月从山东济南、青岛、泰安地区分离的189株淋病奈瑟菌(neisseria gonorrhoeae,NG)临床菌株,对环丙沙星、青霉素、四环素、头孢曲松、阿奇霉素,以及大观霉素等6种常用抗生素的耐药性进行分析,为临床淋病的治疗提供依据。方法采用琼脂稀释法测定189株临床分离菌株对6种抗生素的最小抑菌浓度(MIC)值。采用产色头孢硝噻吩纸片法检测产β-内酰胺酶NG菌株(PPNG)。结果 NG对头孢曲松、阿奇霉素、和大观霉素的敏感率分别为98.41%、97.88%、98.94%;对环丙沙星、青霉素、四环素等几种传统抗生素的耐药率分别为95.77%、96.3%、96.83%。检出PPNG 75株(39.7%),TRNG77株(40.7%)。结论青霉素、环丙沙星及四环素等药物已不适用于本地区淋病的治疗,头孢曲松可作为治疗的首选药物,可同时用阿奇霉素进行联合治疗,三代头孢类药物过敏时可用大观霉素。

Objective：To analyze the antimicrobial susceptibility tests of the 189 N. gonorrhoeae isolates for clinical determination of optimal treatment regimens. Methods：189 N. gonorrhoeae isolates were randomly selected from the hospitals in Tai＇an,Qingdao and Jinan of Shandong Province during June,2014-June,2016. Antimicrobial susceptibility testing was performed using the agar dilution method. All the isolates were tested against penicillin（PEN）,ceftriaxone（CRO）,tetracycline （TET）,azithromycin（AZM）,ciprofloxacin（CIP）,and spectinomycin（SPT）. The beta-lactamase producing of PPNG isolates were determined using the nitrocefin test（Oxoid）. Results：The resistance rate of N. gonorrhoeae against CIP,PEN, and TET were 95. 77% ,96. 3% ,and 96. 83% ,respectively. At the same time,the susceptibility rate of N. gonorrhoeae against CRO,AZM,and SPE were 98. 41% ,97. 88% and 98. 94% ,respectively. The PPNG and TRNG accounted for 39. 7% and 40. 7% of the N. gonorrhoeae isolates,respectively. Conclusion：Ceftriaxone only or combined with azithromycin remain to be the first line therapy for N. gonorrhoeae infections in this district in China. When available,spectinomycin is an effective alternative for the treatment of N. gonorrhoeae infections in the presence of cephalosporin allergy.