淋球菌耐药监测结果分析

Analysis of antibiotic resistance of Neisseria gonorrhoeae

目的监测2019年12月至2020年11月收集的淋球菌耐药性,为淋病防治提供策略。方法采用琼脂稀释法,检测2019年12月至2020年11月广州市皮肤病防治所门诊临床分离培养的100株淋球菌,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(minimum inhibitory concentration,MIC),分析淋球菌耐药性,判定质粒介导的高度耐四环素淋球菌(highly tetracycline resistant Neisseria gonorrhoeae,TRNG),同时用纸片碘量法检测β-内酰胺酶,筛查产青霉素酶淋球菌(penicillinase producing Neisseria gonorrhoeae,PPNG)。结果PPNG阳性率为46%(46/100),TRNG阳性率为35%(35/100)。青霉素、四环素、环丙沙星和阿奇霉素耐药率分别是95%(95/100)、88%(88/100)、97%(97/100)、16%(16/100);头孢克肟和头孢曲松未见耐药菌株,低敏率分别为11%(11/100)和4%(4/100);大观霉素未发现耐药菌株和低敏菌株。结论广州市淋球菌临床分离株普遍对青霉素、环丙沙星、四环素耐药,治疗淋病的首选药仍是大观霉素、头孢曲松和头孢克肟,淋球菌耐药监测应定期进行。

Objective To survey the antibiotic resistance of clinically isolated Neisseria gonorrhoeae from December 2019 to November 2020,and to provide strategies for gonorrhea control.Methods A total of 100 strains of Neisseria gonorrhoeae isolated from the outpatient department of Guangzhou Institute of Dermatology from December 2019 to November 2020 were detected.The minimum inhibitory concentrations(MICs)of penicillin,tetracycline,ciprofloxacin,spectinomycin,azithromycin,ceftriaxone,and cefixime were determined by the agar dilution method.The resistance of Neisseria gonorrhoeae was analyzed,the plasmid mediated highly tetracycline resistant Neisseria gonorrhoeae(TRNG)was determined,andβ-lactamase was detected by the paper iodometry to screen penicillinase producing Neisseria gonorrhoeae(PPNG).Results The positive rate was 46%(46/100)for PPNG and 35%(35/100)for TRNG.The resistance rates to penicillin,tetracycline,ciprofloxacin,and azithromycin were 95%(95/100),88%(88/100),97%(97/100),and 16%(16/100),respectively.Cefixime and ceftriaxone had no drug resistance,and the low sensitivity rates were 11%(11/100)and 4%(4/100),respectively.No drug-resistant and hyposensitive strains to spectinomycin were found.Conclusions Clinical isolates of Neisseria gonorrhoeae in Guangzhou were generally resistant to penicillin,ciprofloxacin,and tetracycline.Spectinomycin,ceftriaxone,and cefixime are still the first choice of antibiotics in the treatment of gonorrhea.The antibiotic susceptibility of Neisseria gonorrhoeae should be monitored regularly.