粤西部分地区淋病奈瑟菌耐药性及mtrR基因突变特点研究

Drug resistance and mtrR gene mutation characteristics of Neisseria gonorrhoeae in part of western Guangdong

目的探讨粤西部分地区淋病奈瑟菌(NG)耐药性及mtrR基因突变特点。方法收集180株来源于粤西部分地区的NG。运用琼脂稀释法检测抗生素的最小抑菌浓度;采用荧光定量聚合酶链反应和测序分析对比两组mtrR基因的突变点。结果大观霉素(SP)和环丙沙星的敏感率分别100.00%和0。mtrR基因总突变率为48.33%(87株),其中A缺失占3.89%(7株)、H14R占11.67%(21株)、G45D占19.44%(35株)、F51V占8.89%(16株)和H105Y占4.44%(8株)。mtrR基因突变株的头孢曲松、四环素(TC)和阿奇霉素敏感率均明显低于mtrR基因正常株(P<0.05)。青霉素(P)耐药株mtrR基因的总突变率明显高于P中介株(P<0.05)。与TC耐药株相比,TC中介株G45D的发生率明显低,F51V的发生率明显高,mtrR基因的总突变率明显低(P<0.05)。结论在粤西部分地区,SP可作为治疗NG感染的首选药物。mtrR基因突变的NG容易产生耐药性,其中mtrR基因突变以G45D最为常见。

Objective To investigate the drug resistance and mtrR gene mutation characteristics of Neisseria gonorrhoeae(NG)in part of western Guangdong.Methods A total of 180 NG were collected.The minimum inhibitory concentration of antibiotics was detected by agar dilution method,and the mutation points of mtrR gene were compared between the two groups by PCR and followed by sequencing analysis.Results The sensitivity rates of spectinomycin(SP)and ciprofloxacin were 100.00%and 0,respectively.The total mutation rate of mtrR gene was 48.33%(87 strains),in which A deletion accounted for 3.89%(7 strains),H14R for 11.67%(21 strains),G45D for 19.44%(35 strains),F51V for 8.89%(16 strains)and H105Y for 4.44%(8 strains).The sensitivity rate of ceftriaxone,tetracycline(TC)and azithromycin in mtrR gene mutant strains were significantly lower than that in mtrR gene normal strains(P<0.05).The total mutation rate of mtrR gene in penicillin(P)resistant strains was significantly higher than that in P-mediated strains(P<0.05).Compared with TC resistant strains,the incidence of G45D was significantly lower.The incidence of F51V was significantly higher,and the total mutation rate of mtrR gene was significantly lower(P<0.05).Conclusion In some areas of western Guangdong,SP can be used as the first choice drug for the treatment of NG infection.NG mutation of mtrR gene is easy to produce drug resistance,and G45D is the most common mutation of mtrR gene.