淋病流行特征与淋球菌药物敏感性的流行病学研究

Tbe Epidemiological Study on Drugs Sensitivity of Gonococcal Isolates and Gonorrhoeae Epidemic Characteristics

目的 为控制淋病的增长,探讨淋病流行病特征与淋球菌对常用药物敏感性的流行病学关系。方法 完整收集淋病的流行病学资料,测定每年淋球菌对各种药物的敏感度及耐药率,药物包括青霉素、四环素、环丙沙星、壮观霉素和头孢三嗪。结果 性病流行在10年内稳定上升,但淋病则由1993年开始呈稳定的负增长。壮观霉素及头孢三嗪在4年间未发现耐药菌株;环丙沙星的耐药率显著上升,由1998年的56.4％上升至2001年的71.4％,产青霉素的耐药菌株(PPNG)和四环素耐药菌株(TRNG)在4年内分别上升10％和16.3％。结论 随淋病的有效控制,淋球菌对常用药物的敏感性降低,PPNG和TRNG菌株的明显上升表明淋球菌的耐药趋势正逐渐增强。喹诺酮类药物的高耐药率表明该类药物已不再适宜被推荐用于治疗淋病的首选药物。头孢三嗪和壮观霉素尚没有耐药菌株,但必须强调规范使用,保证在性病防治工作中有足够可供选择的有效药物。

Objective To slow down the increasing of the STDs and get it under control!, and to investigate gonorrhoeae epidemic characteristics and drugs sensitivity . The regression relation between gonorrhoeae epidemic trend and drug sensitivity has been analyzed. Methods Gonorrhoeae epidemic date have been collected and five drugs sensitivity were tested for GC isolated in individual year.The 5 drugs were penicillin, ciprofoxacin spectinomycin.tetracyclin and ceftriaxone. Results STDs incidence was increased during last decade, the gonorrhoeae was negative increased from 1993.Ceftriazone and spectinomycin showed no resistant isolate during the last four years. The resistant rate of ciprofoxacin was increased to a high level, which increased from 56.5% in 1998 to 71.4% in 2001 .PPHG and TRNG growing with each passing year and raised by 10% and 16.3% respectively.Conclusion With the gonorrhoeae under controlled, the drug sensitivity of gonococcal isolated for common recommended medications were decreased year by year, the high rate of PPNG and TRNG in the investigation indicated that the tendency of drug resistant in gonococci isolates was growing.The ciprofoxacin showed a high resistant in drug sensitive test for gonococci isolates, the medication is not worth to be recommended to use in treatment of gonococci infection. Ceftriaxone and spectinomycin showed good response in test and those two drugs were still the first choice for gonococci infection, but suitable indications and monitoring the utilization in clinical practice for the sensitivity is a way to keep those medication can be lasted for a longer years.