2018-2021年天津地区淋病奈瑟菌耐药情况分析

Drug resistance of Neisseria gonorrhoeae in Tianjin from 2018 to 2021

目的 了解天津地区淋病奈瑟菌对抗生素的耐药情况,为治疗淋病提供实验室依据。方法 采用琼脂稀释法,对2018-2021年天津市收集到的308株淋病奈瑟菌临床分离株进行检测,测定其对青霉素、四环素、环丙沙星、头孢曲松、大观霉素、阿奇霉素6种抗生素的最低抑菌浓度(MIC),并判断其耐药性。结果 308株淋病奈瑟菌,其中产青霉素酶的淋病奈瑟菌株(PPNG)占36.69%(113株)、质粒介导的高度耐四环素淋病奈瑟菌株(TRNG)占24.68%(76株)。环丙沙星耐药率高达99.03%(305株),青霉素耐药率81.17%(250株),阿奇霉素耐药率25.97%(80株),四环素耐药率24.68%(76株),未发现对大观霉素和头孢曲松耐药的菌株;发现32株(10.39%)对阿奇霉素耐药同时对头孢曲松中敏的淋病奈瑟菌。全基因测序一株淋病奈瑟菌,发现22个与耐药相关的基因。结论 大观霉素和头孢曲松为主的一线治疗药物,适合天津现阶段淋病的临床治疗,但是仍需要长期监测耐药性变化。

Objective e To investigate the antibiotic resistance of Neisseria gonorrhoeae in Tianjin,so as to provide laboratory evidence for the treatment of gonorrhea.Methods Totally 308 clinical isolates of Neisseria gonorrhoeae were collected in Tianjin from 2018 to 2021 by agar dilution.The lowest inhibitory concentrations(MICs)of Neisseria gonorrhoeae against 6 kinds of antibiotics including penicillin,tetracycline,ciprofloxacin,ceftriaxone,spectinomycin and azithromycin were determined,and the resistance of that was evaluated.Results Among the 308 strains of Neisseria gonorrhoeae,36.69%(113 strains)of which were penicillinase-producing Neisseria gonorrhoeae strains(PPNG)and 24.68%(76 strains)were high-level tetracycline resistant Neisseria gonorrhoeae strains(TRNG).The resistance rate of ciprofloxacin,penicillin,azithromycin,and tetracycline was 99.03%(305 strains),81.17%(250 strains),25.97%(80 strains),and 24.68%(76 strains),respectively.There was no strains resistant to spectinomycin and ceftriaxone.32 strains(10.39%)were resistant to azithromycin and moderately sensitive to ceftriaxone.Whole gene sequencing of a strain of Neisseria gonorrhoeae revealed 22 genes associated with drug resistance.Conclusions sSpectinomycin and ceftriaxone-based first-line drugs are suitable for the clinical treatment of gonorrhea in Tianjin,but long-term monitoring of drug resistancechanges is still required.