武陵山区淋病奈瑟菌对7种抗菌药物的耐药情况及分子生物学特征分析

Analysis of biological characteristics of Neisseria gonorrhoeae and its resistance to the seven kinds of antibiotics at Wuling mountain area

目的通过监测武陵山区淋病奈瑟菌的抗菌药物耐药情况及分子生物学特征,了解该地区是否存在头孢曲松耐药菌株及相关流行病学信息。方法回顾性分析2018年4月1日至2019年3月31日该地区培养分离出的122株淋病奈瑟菌的临床资料。药敏试验参考欧洲药敏试验委员会(EUCAST)标准,采用K-B法和琼脂稀释法检测淋病奈瑟菌对头孢曲松和阿奇霉素等7种抗菌药物的敏感性。采用多抗原序列分型法(NGMAST)对头孢曲松低敏感性及耐药菌株进行基因分型,并用MEGA6构建POR和TBPB基因系统发育树。结果 122株淋病奈瑟菌株对头孢曲松、头孢泊肟、头孢克肟、壮观霉素、阿奇霉素、四环素和环丙沙星的敏感率分别为98.36%、92.62%、90.16%、81.15%、78.69%、37.70%和12.29%。2株头孢曲松耐药菌株最低抑菌浓度(MIC)分别为1.000μg/mL和0.250μg/mL,NG-MAST型分别为ST2987型和ST14155型。结论该研究发现1株高水平头孢曲松耐药的淋病奈瑟菌,但未发现流行病学同源耐药菌株。武陵山区淋病奈瑟菌耐药形势严峻,应严控头孢曲松耐药菌株传播。

Objective To understand whether there are ceftriaxone resistant strains and related epidemiological information by monitoring the drug resistance and molecular biological characteristics of Neisseria gonorrhoeae in Wuling mountain area.Methods A retrospective study was conducted to analyze the clinical data of 122 Neisseria gonorrhoeae strains isolated from April 1,2018 to March 31,2019.The susceptibility test was carried out by referring to the EUCAST standard.The sensitivity of Neisseria gonorrhoeae to 7 kinds of antibiotics such as ceftriaxone and azithromycin were measured by K-B method and agar dilution method.And strains with ceftriaxone low sensitivity strains and resistant strains were genotyped by NG-MAST.POR and TBPB gene phylogenetic trees were constructed with MEGA6.Results The sensitivity rates of 122 Neisseria gonorrhoeae strains to ceftriaxone,cefpodoxime,cefaclor,spectinomycin,azithromycin,tetracycline and ciprofloxacin were 98.36%,92.62%,90.16%,81.15%,78.69%,37.70%and 12.29%,respectively.The minimum inhibitory concentration(MIC)values of the two ceftriaxone resistant strains were 1.000μg/mL and 0.250μg/mL,and genotype of NG-MAST of two ceftriaxone resistant strains were ST2987 and ST14155,respectively.Conclusion The research has reported one strain of high-level ceftriaxone-resistant Neisseria gonorrhoeae,but epidemiologically homologous strains haven′t found.The transmission of resistant strains to ceftriaxone should be strictly controlled,because the drug resistance of Neisseria gonorrhoeae is severe in Wuling mountain area.