159株淋球菌对7种抗生素的耐药性实验研究

The resistance of neisseria gonorrhoeaeto to seven antimicrobial agents in vitro

目的 通过实验研究了解本地区淋球菌对7种抗生素的耐药情况、产β-内酰胺酶淋球菌(PPNG)和质粒介导高度耐四环素淋球菌(TRNG)流行情况。方法 用琼脂稀释法测定环丙沙星、四环素、青霉素、阿奇霉素、大观霉素、头孢曲松和头孢克肟的最低抑菌浓度(MIC),根据世界卫生组织(WHO)的标准判定其敏感性;用纸片酸度法检测β-内酰胺酶。结果 159株淋球菌检出PPNG为78.9%,TRNG为48.4%,多重耐药菌株占比73.6%;对环丙沙星、四环素、青霉素、阿奇霉素的耐药率分别是100%、89.9%、89.3%、14.5%;对大观霉素、头孢曲松、头孢克肟的敏感率分别为100%、95.6%和92.5%。结论 本地区淋病患者不宜使用青霉素、四环素、环丙沙星和阿奇霉素,大观霉素、头孢曲松和头孢克肟均可作为治疗药物。多重耐药菌株比例增高,应长期动态监测耐药性变化。

Objective To analyze antimicrobial resistance of Neisseria gonorrhoeae(NG)to seven antimicrobial agents and the penicillinase-producing NG(PPNG)and tetracycline resistantNG(TRNG)in Kunmingfrom2019to2020.Methods One hundred fi fty-nine NG strains were isolated and cultured fromour clinical department.Minimum inhibitory concentration(MIC)ofciprofl oxacin,tetracycline,penicillin,azithromycin,spectinomycin,ceftriaxone,cefi xime weredetermined by agar dilution method;β-lactamase was measured by paper iodinequantitative method.Results PPNG and TRNG accounted for 78.9%and 48.4%of the NG isolatesrespectively,and the proportion of multiple drug-resistant strains was 73.6%.The resistant rate of ciprofl oxacin,tetracycline,penicillin,azithromycin were 100%,89.9%,89.3%and14.5%,respectively.The sensitivity rate of spectinomycin,ceftriaxone and cefi xime were 100%,95.6%and 92.5%,respectively.Conclusion Penicillin,tetracycline,ciprofl oxacin and azithromycin should not be used in patients with gonorrhoeae in Kunming,while spectinomycin,ceftriaxone and cefi xime can be used as treatment options for gonorrhoeae.The increasing proportion of multi-drug resistant strains suggests that the dynamic changes of drug resistance should be monitored for a long time.