2018-2022年中山地区淋球菌耐药结果分析

Analysis of Drug Eesistance of Neisseria Gonorrhoeae in Zhongshan from 2018 to 2022

目的 了解中山地区淋球菌流行株对常见7种抗生素的耐药趋势,为本地区淋病临床防治提供有效实验室依据。方法 对2018-2022年中山地区东、南、西、北和中部12间医疗机构收集的淋球菌株进行复苏、分纯和鉴定后,采用WHO推荐的琼脂稀释法,对7种抗生素(青霉素、四环素、环丙沙星、头孢曲松、头孢克肟、大观霉素、阿奇霉素)进行最低抑菌浓度(MIC)测定,用纸片酸度法检测其β-内酰胺酶。结果 5年间共监测淋球菌943株,其对青霉素、四环素、环丙沙星、阿奇霉素(2020-2022年)、大观霉素的平均耐药率分别为84.73%、93.85%、99.79%、12.74%;头孢曲松、头孢克肟的平均中敏率分别为8.70%、11.98%,PPNG株(30.57%~64.39%)(χ^(2)=51.985,P<0.01)和TRNG株(30.57%~52.68%)(χ^(2)=30.931,P<0.01)呈显著的上升趋势。结论 青霉素、四环素、环丙沙星均保持稳定的高耐药率,已不适用于临床治疗;头孢菌素(中敏率)、阿奇霉素、大观霉素呈较低耐药率,仍可推荐为本地区治疗淋病的首选药物。

Objective To understand the trend of resistance of gonococcal epidemic strains to 7 common antibiotics in Zhongshan area and provide effective laboratory basis for clinical prevention and treatment of gonorrhea in this area.Methods The Neisseria gonorrhoeae strains collected from 12 medical institutions in the east,south,west,north and central part of Zhongshan region from 2018 to 2022 were recovered,purified and identified,and the minimum inhibitory concentration(MIC)of 7 antibiotics(penicillin,tetracycline,ciprofloxacin,ceftriaxone,cefixime,spectinomycin,azithromycin)was determined by the agar dilution method recommended by WHO,and the paper acidity method was used to detectβ-Lactamases.Results A total of 943 strains of Neisseria gonorrhoeae were monitored in the past five years.The average resistance rates to penicillin,tetracycline,ciprofloxacin,azithromycin(2020-2022)and spectinomycin were 84.73%,93.85%,99.79%and 12.74%respectively;The average medium sensitivity rates of ceftriaxone and cefixime were 8.70%and 11.98%,respectively.PPNG(30.57%~64.39%)(2=51.985,P<0.01)and TRNG(30.57%~52.68%)(2=30.931,P<0.01)showed a significant upward trend.Conclusion Penicillin,tetracycline and ciprofloxacin all maintain stable high drug resistance rate,which is not suitable for clinical treatment;Cephalosporin(medium sensitivity rate),azithromycin,and spectinomycin showed a low drug resistance rate,which could still be recommended as the first choice for the treatment of gonorrhea in the region.