1999-2002年南京地区淋球菌分离株抗生素敏感性监测

Surveillance of Antimicrobial Susceptibilities of Neisseria gonorrhoeae in Nanjing City, 1999-2002

目的监测南京地区淋球菌对抗生素的耐药性,报告1999-2002年的结果.方法采用纸片酸度定量法测定菌株是否产β-内酰胺酶.采用琼脂稀释法测定青霉素、四环素、环丙沙星、大观霉素和头孢曲松对淋球菌的最小抑菌浓度(MIC).结果共对417株淋球菌进行了检测,产青霉素酶淋球菌(PPNG)的阳性率由1999年的8.0%上升到2002年的31.31%(P＜0.001),质粒介导的耐四环素淋球菌(TRNG)的阳性率由1999年的1.8%上升到2002年的22.2%(P＜0.001).在非PPNG中,染色体介导的青霉素耐药菌株的阳性率介于64.08%～87.80%.耐环丙沙星淋球菌的阳性率介于83.93%～97.17%.未检出对头孢曲松耐药的淋球菌,但低敏菌株的比例从1999年的17.9%上升到2002年的50.5%(P＜0.005).在2001与2002年各检测出1株对大观霉素耐药的淋球菌.结论南京地区分离的淋球菌中,质粒介导的耐药性(包括PPNG和TRNG)增长速度较快,染色体介导的对青霉素和环丙沙星耐药的淋球菌比例很高,大观霉素耐药性淋球菌偶见.头孢曲松和大观霉素为治疗淋病的有效药物.

Objective To monitor antibiotic resistance of Neisseria gonorrhoeae in Nanjing City based on analysis of the results from 1999 to 2002. Methods The production of β-lactamase was determined by paper acidometric method. Minimum inhibitory concentrations (MICs) of penicillin, ceftriaxone, tetracycline, ciprofloxacin and spectinomycin were determined by an agar plate dilution method. Results A total of 417 clinical isolates of Neisseria gonorrhoeae were examined. During the period of 1999-2002, positive rate of PPNG rapidly increased from 8.0% to 31.31% (P < 0.005). Prevalence of TRNG increased from 1.8% in 1999 to 22.2% in 2002 (P < 0.005). Among non-PPNG isolates, prevalence of chromosomally mediated resistance to penicillin ranged from 64.08% to 87.80%. Positive rate of chromosomal resistance to ciprofloxacin was between 83.93% and 97.17%. There was no gonococcal isolate resistant to ceftriaxone, but the prevalence of strains less susceptible to ceftriaxone rose from 17.9% in 1999 to 50.5% in 2002. One Neisseria gonorrhoeae strain resistant to spectinomycin each was detected in 2001 and 2002. Conclusions Among Neisseria gonorrhoeae strains isolated in Nanjing City, plasmid mediated resistance (including PPNG and TRNG) has increased rapidly, and the proportions of chromosomally mediated resistance to both penicillin and ciprofloxacin are high. Spectinomycin-resistant Neisseria gonorrhoeae strain is rarely seen. Ceftriaxone and spectinomycin are considered as effective drugs for the treatment of gonorrhea.