100株淋球菌对7种抗生素的耐药性结果分析

Analysis of the resistance to 7 antimicrobial agents in 100 strains of Neisseria gonorrhoeae

目的:监测2019年本单位淋球菌对7种抗生素的耐药性趋势及产青霉素酶淋球菌(PPNG)和质粒介导的高度耐四环素淋球菌(TRNG)流行情况,为临床有效选择抗生素提供实验室依据。方法:收集本单位门诊临床分离培养的100株淋球菌,用琼脂稀释法测定青霉素、四环素、环丙沙星、大观霉素、阿奇霉素、头孢曲松、头孢克肟的最低抑菌浓度(MIC);用纸片碘量法检测β-内酰胺酶。结果:产青霉素酶淋球菌(PPNG)株占35%(35/100),质粒介导的高度耐四环素淋球菌(TRNG)株占32%(32/100)。环丙沙星和青霉素的耐药率分别高达99%(99/100)、93%(93/100)。阿奇霉素耐药率达10%(10/100)。头孢曲松和头孢克肟未见耐药菌株,低敏率分别为22%(22/100)和19%(19/100),敏感率分别为78%(78/100)和81%(81/100)。大观霉素未发现耐药菌株和低敏菌株。结论:头孢曲松、头孢克肟、大观霉素仍可推荐为广州地区淋病患者首选药物。建议临床制定合理抗菌治疗方案以提供科学指导时,应长期监测淋球菌耐药性。

Objective:To analyse antimicrobial resistance of Neisseria gonorrhoeae to 7 antimicrobial agents and the penicillinase-producing Neisseria gonorrhoeae(PPNG)and tetracycline resistant Neisseria gonorrhoeae(TRNG)in Guangzhou during 2019.Methods:100 Neisseria gonorrhoeae strains were isolated and cultured from our clinical department.Minimum inhibitory concentration(MIC)of penicillin,tetracycline,ciprofloxacin,spectinomycin,azithromycin,ceftriaxone,cefixime was determined by agar dilution method.β-lactamase was measured by paper iodine quantitative method.Results:PPNG and TRNG accounted for 35%(35/100)and 32%(32/100)of the Neisseria gonorrhoeae isolates,respectively.The antibiotic resistant rate of ciprofloxacin,penicillin and azithromycin was 99%(99/100)、93%(93/100)and 10%(10/100).Both moderate sensitivity rate of ceftriaxone and cefixime were 22%(22/100)and 19%(19/100),both sensitivity rate accounted for 78%(78/100)and 81%(81/100).All isolates were susceptible to spectinomycin.Conclusion:The resistant strains to spectinomycin,ceftriaxone and cefixime were not found and these antibiotics can still be used as the first drug for the treatment of Neisseria gonorrhoeae in Guangzhou.However,the dynamic changes in moderate sensitivity rate of ceftriaxone and cefixime show that it is essential to continuously monitor antimicrobial resistance of Neisseria gonorrhoeae for providing theoretical guidance to clinical rational antibacterial treatment.