2019-2021年四川成都某医院淋病奈瑟菌对大观霉素、阿奇霉素及头孢菌素类药物敏感性检测及结果分析

The analysis of antimicrobial susceptibility test of Neisseria gonorrhoeae to spectinomycin,azithromycin and cephalosporins in one hospital of Chengdu,Sichuan Province from 2019 to 2021

目的检测我院2019—2021年淋病奈瑟菌临床分离菌株对大观霉素、阿奇霉素及头孢菌素类药物的敏感性,为淋病的治疗和防控提供参考。方法收集并保存淋病奈瑟菌临床分离株,琼脂稀释法和微量肉汤稀释法测定大观霉素、阿奇霉素、头孢曲松和头孢克肟的最小抑菌浓度(MIC),分析比较菌株对各药物的耐药率或低敏率。结果2019—2021年共分离收集淋病奈瑟菌菌株279株。其中未发现对大观霉素的耐药菌株;发现对阿奇霉素耐药菌株31株,耐药率分别为16.00%、8.82%和8.11%,平均耐药率为11.11%;发现对头孢曲松低敏菌株43株,低敏率分别为12.00%、14.71%和18.92%,平均低敏率为15.41%;发现对头孢克肟低敏菌株27株,低敏率分别为4.00%、2.94%和18.92%,平均低敏率为9.68%。每年发现同时对头孢曲松低敏和阿奇霉素耐药的菌株数量均为2株,占比分别为2.00%、2.94%和1.80%,总体占比2.15%。结论大观霉素和头孢曲松仍适合本地区作为治疗淋病的一线药物,需关注本地区淋病奈瑟菌对头孢曲松低敏率的逐年增长趋势。

Objective To test the susceptibility of Neisseria gonorrhoeae clinical isolates to spectinomycin,azithromycin,and cephalosporins in our hospital from 2019 to 2021,and provide a reference for treatment,prevention,and control of gonorrhea.Methods Clinical isolates of Neisseria gonorrhoeae were collected and preserved,and the minimum inhibitory concentration(MIC)of spectinomycin,azithromycin,ceftriaxone,and cefixime were determined by the agar dilution method and the broth dilution method,and the drug resistance rate or low sensitivity rate of strains to each drug was analyzed.Results A total of 279 Neisseria gonorrhoeae strains were isolated and collected from 2019 to 2021.There was no spectinomycin-resistant strain.Thirty-one strains were found to be resistant to azithromycin,and the drug resistance rates were 16.00%,8.82%,and 8.11%from 2019 to 2021,with an average azithromycin-resistance rate of 11.11%.Forty-three strains were found to be hyposensitive to ceftriaxone,and the hyposensitivity rates were 12.00%,14.71%,and 18.92%from 2019 to 2021,with an average hyposensitivity rate of 15.41%.Twenty-seven strains were found to be hyposensitive to cefixime,and the hyposensitivity rates were 4.00%,2.94%,and 18.92%from 2019 to 2021,and the average hyposensitivity rate was 9.68%.Two ceftriaxone hypoallergenic and azithromycin resistant strains were found each year,accounting for 2.00%,2.94%,and 1.80%from 2019 to 2021,and the overall ratio was 2.15%.Conclusion Spectinomycin and ceftriaxone are still suitable as first-line drugs for the treatment of gonorrhea in this region.It is necessary to pay attention to the increasing trend of low sensitivity rate of Neisseria gonorrhoeae to ceftriaxone with each passing year in this region.