淋病流行特征与淋球菌药物敏感性的流行病学研究

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有效药物。     

200株淋球菌耐药检测结果分析

目的了解本院分离的200株淋球菌对壮观霉素、头孢曲松、头孢克肟、环丙沙星、青霉素和四环素的耐药性,分析耐药菌株的流行特点,指导临床合理用药。方法采用琼脂稀释法测定菌株对6种抗菌素的最小抑菌浓度(MIC),判断敏感性按WHO西太平洋地区淋球菌耐药性监测统一标准。用纸片酸度法监测产β-内酰胺酶淋球菌(PPNG)菌株。结果 200株淋球菌中,对6种抗菌素的耐药率以环丙沙星为首,耐药率高达94.5%;其次是青霉素,耐药率达92.0%,其中产β-内酰胺酶淋球菌(PPNG)49株(24.5%);四环素耐药率为67.5%,其中质粒介导高度耐四环素淋球菌(TRNG)56株,占28.0%;未发现头孢曲松、头孢克肟耐药菌株,但其低敏率分别为7.0%,5.5%,未发现壮观霉素耐药菌株和低敏菌株;环丙沙星、青霉素和四环素MIC50及MIC90均已超过耐药标准;二重耐药青霉素和环丙沙星同时耐药共检出139株(69.5%)最高,青霉素、四环素和环丙沙星同时耐药109株(54.5%)。结论环丙沙星、青霉素和四环素耐药率较高,提示对淋病的治疗效果差;壮观霉素、头孢曲松和头孢克肟的敏感性较高,推荐壮观霉素、头孢曲松和头孢克肟作为本地区治疗淋病的首选药物,同时定期监测淋球菌的耐药性,以指导临床合理应用抗菌素。     

深圳市淋球菌分离株抗生素耐药性分析

目的 了解广东省深圳市淋病双球菌对抗生素的耐药性及产β内酰胺酶淋病双球菌(PPNG)和高水平耐四环素淋病双球菌(TRNG)的流行状况.方法 采用琼脂稀释法测定5种抗生素对240株淋病双球菌的最低抑菌浓度(MIC);用改良碘定量法检测PPNG菌株.结果 淋病双球菌对青霉素、四环素、环丙沙星及头孢三嗪的耐药率分别为71.67%,78.33%,37.50%及6.67%;检出32株PPNG菌株,占13.33%;检出30株TRNG菌株占12.5%;同时对青霉素、四环素、环丙沙星耐药的菌株占31.67%.结论 壮观霉素、头孢三嗪仍可作为深圳市治疗淋病的首选用药,但淋球菌对四环素及青霉素的耐药率较高.     

常德地区淋球菌流行株的药物敏感性检测

目的 了解淋球菌流行株对抗菌药物的敏感性,为淋病的防治提供实验依据.方法 改良碘量法检测β-内酰胺酶,纸片扩散法检测98株淋球菌对9种抗菌药物的敏感性.结果 质粒介导的产青霉素酶淋球菌(PPIVG)和质粒介导的高度耐四环素淋球菌(TRNa)分别为55株(56.12%)和20株(23.47%),在测定的9种抗菌药物中,淋球菌耐药性较高的依次为四环素、头孢美唑、青霉素、环丙沙星、氧氟沙星.耐药率分别为36.73%、50%、56.12%、74.45%、80.61%,而敏感性较高的4种抗菌药物依次为头孢呋辛、头孢三嗪、头孢呲肟、壮观霉素,敏感率分别为72.44%、79.60%、77.55%、91.84%.结论 青霉素、四环素以及氟喹诺酮类药物已不宜作为常德地区治疗淋病的常规药物,壮观霉素可作为治疗淋病的首选药物,但已出现耐药菌株,应当引起高度警惕.     

测定淋球菌对抗生素敏感性的方法学评价

淋病是我国目前性传播疾病 (ＳＴＤ)中发病率最高的病种。随着淋球菌耐药菌株的逐年增多 ,需加强耐药性的监测。监测淋球菌耐药性 ,常用的有纸片扩散法、琼脂稀释法及Ｅ试验法。本文用纸片扩散法和琼脂稀释法测定淋球菌对青霉素、四环素、壮观霉素、头孢三嗪和环丙沙星的敏感性 ,利用统计学处理比较这两种方法 ,并加以方法学评价 ,从而为药敏试验提供一种敏感、可靠及简便的方法。现报道如下。材料和方法　 (1)菌株来源 :从 1998～ 1999年本院附属医院、湛江市第二人民医院、湛江市农垦医院皮肤性病门诊病人中分离出 98株淋球菌。其中男性病…     

上海某院淋球菌株对常用抗生素耐药性观察

淋病是目前世界上发病人数最多的性传播疾病之一，由于菌株的变异和滥用抗生素，自1976年美国发现2例耐青霉素治疗的淋球菌病例以来，淋球菌对青霉素等抗生素耐药菌株不断增加。目前临床上多应用壮观霉素、头孢三嗪和氟喹诺酮类药物对其治疗。但由于这些药物的广泛使用、细菌染色体突变及耐药基因转移等原因，淋球菌逐渐产生了对这些抗生素的耐药菌株。为了解上海地区淋球菌流行株的耐药现状，我们采用琼脂稀释法对1995年和2005年临床分离的淋球菌菌株对青霉素、头孢曲松及环丙沙星的敏感性进行测定，现将结果报道如下。     

淋球菌流行株对抗生素的耐药性研究

目的：了解淋球菌流行株对抗生素的耐药性。方法：对１９９８ ～１９９９ 年间广东省湛江地区分离出的９８ 株淋球菌流行株，在系统鉴定的基础上，进行了抗生素敏感性的测定，分别用纸片扩散法和琼脂稀释法测定青霉素、四环素、壮观霉素、头孢三嗪和环丙沙星的抑菌圈直径（ ｍ ｍ ） 和最小抑菌浓度（ ＭＩＣ） ，根据ＮＣＣＬＳ 标准判定药物敏感性。结果：纸片扩散法测定淋球菌对这５ 种抗生素的耐药百分率分别为３２－６５ ％ 、６９－３９ ％ 、８－１６ ％ 、１３－２７ ％ 和８２－６５ ％ ，而琼脂稀释法测得相应的耐药 百分 率为 ２３－９１ ％ 、４９－４６ ％ 、１１－１１ ％ 、１６－４８ ％ 和５９－３４ ％ 。结论：湛江地区目前流行的淋球菌菌株耐药状况十分严重，尤以环丙沙星为甚，临床常用的头孢三嗪、壮观霉素耐药株也应引起重视     

武鸣县182例淋球菌药敏检测结果分析

目的了解淋球菌对抗菌药物的耐药情况,为制定淋病防治措施提供参考依据。方法采集2012年2月至2015年5月在某医院性病门诊就诊患者样品获得182株淋球菌,用纸片扩散法测定淋球菌对抗生素的敏感性。结果在检测的182株淋球菌中,对青霉素、四环素、环丙沙星、头孢曲松和大观霉素的耐药率分别为70.3%、62.4%、92.3%,0.5%和0.5%。结论淋球菌对环丙沙星、四环素及青霉素的耐药情况比较严重,也出现了个别耐头孢曲松和耐大观霉素的淋球菌菌株,淋球菌的药敏检测结果对淋病临床治疗有一定的指导意义。     

98株淋病奈瑟菌药敏实验结果分析

[目的]监测河南地区淋病奈瑟菌药物敏感情况。[方法)以98株淋病奈瑟菌临床分离株为对象，分别以纸片酸度法进行β-内酰胺酶测定，以琼脂稀释法进行四环素、环丙沙星、壮观霉素和头孢曲松四种抗生素耐药性测定。[结果)检出产质粒介导的β-内酰胺酶菌(PPNG)9株，四环素耐药株39株，环丙沙星耐药株98株，壮观霉素耐药株3株，39株耐四环素和环丙沙星，3株耐四环素和壮观霉素，3株耐环丙沙星和壮观霉素。[结论)河南地区流行的淋病奈瑟菌株对青霉素、四环素和环丙沙星已产生广泛的耐药性，对壮观霉素的耐药性应该高度重视，目前尚未发现对头孢曲松耐药的菌株。     

呼和浩特地区淋球菌对抗生素的敏感性

淋病是目前我国性传播疾病中发病率最高的疾病。随着产β-内酰胺酶菌株（PPNG）和高度耐四环素菌株（TRNG）等耐药菌株的逐渐增多，现临床多应用壮观霉素、头孢三嗪和氟喹诺酮类药物进行治疗。由于广泛使用和临床上不规范治疗，细菌染色体突变及质粒介导引起的耐药性的产生，使淋球菌对上述抗生素的敏感性迅速发生改变，许多地区都出现了耐药菌株。为了解呼和浩特地区淋球菌流行株对抗生素的敏感性，我们采用琼脂稀释法对分离出的淋球菌进行抗生素敏感度即最小抑菌浓度（MIC）测定，现将结果报告如下。     

淋病奈瑟菌标准株外膜蛋白NspA基因重组质粒构建和生物信息分析

[目的]研究淋病奈瑟菌标准株(NG 29403和NG 29400)外膜蛋白NspA基因和NspA融合蛋白结构特点,为淋病奈瑟菌疫苗靶蛋白的选择提供依据。[方法]PCR扩增淋病奈瑟菌标准株NG 29400和NG 29403 NspA基因,与表达质粒pET-30c(g )构建重组子NspA-pET-30c( ),阳性克隆子经双酶切鉴定后进行基因测序。以生物软件对NspA基因进行生物信息分析,并在线预测其蛋白质结构。[结果]成功构建NspA-pET-30c( )重组质粒,双酶切获得0.5kb和5.4kb预期产物。基因序列分析表明淋病奈瑟菌NspA基因有较高同源性,两标准株与GenBank已有序列均有98%同源性,且与脑膜炎奈瑟菌NspA基因高度近似。蛋白预测显示NspA融合蛋白有40%以上为环状结构,可能为主要功能区。三级结构与脑膜炎奈瑟菌NspA相似。[结论]淋病奈瑟菌NspA基因具有高度保守性,与脑膜炎奈瑟菌NspA基因同源性高,蛋白结构相似,有望成为淋病奈瑟菌疫苗的候选抗原。     

Surveillance of antibiotic resistance in Neisseria gonorrhoeae in the WHO Western Pacific Region, 1998. The WHO Western Pacific Gonococcal Antimicrobial Surveillance Programme

Effective treatment of gonorrhoea in the World Health Organization's Western Pacific Region is hampered by the emergence and spread of antibiotic resistant strains of Neisseria gonorrhoeae. A programme of surveillance of gonococcal susceptibility to antibiotics (GASP) continued in the region in 1998. A high proportion of isolates in many participating countries was resistant to quinolones and penicillins, continuing trends observed by this programme since 1992. Resistance to the later generation cephalosporins and to spectinomycin was absent or infrequent. Options for effective treatment of gonorrhoea in the region have been severely compromised by antibiotic resistance.     

妊娠期妇女中四种性病病原体感染情况分析

目的　了解妊娠期妇女中 4种性病病原体的感染情况。　方法　用聚合酶链反应 ( PCR)法对 1785例妊娠期妇女宫颈分泌物进行人乳头状瘤病毒 ( HPV)、沙眼衣原体 ( CT)、解脲脲原体 ( UU)和淋病奈瑟菌 ( NG)检测。　结果　妊娠期妇女 4种性病病原体总阳性率为 5 .77% ( 10 3 /1785 ) ,其中 HPV阳性率 ( 12 .2 4 % )最高 ,CT阳性率 ( 9.3 1% )和 UU阳性率 ( 8.0 0 % )次之 ,NG阳性率 ( 2 .69% )最低 ,4种病原体感染差异有非常显著性 ( P<0 .0 1)。　结论　孕妇中存在着不同程度 4种性病病原体感染     

Surveillance of antibiotic resistance in Neisseria gonorrhoeae in the WHO Western Pacific and South East Asian Regions, 2009

Long-term surveillance of antimicrobial resistance in Neisseria gonorrhoeae has been conducted in the World Health Organization (WHO) Western Pacific Region (WPR) to optimise antibiotic treatment of gonococcal disease since 1992. From 2007, the Gonococcal Antimicrobial Surveillance Programme (GASP) has been enhanced by the inclusion of data from the South East Asian Region (SEAR) and recruitment of additional centres in the WPR. Approximately 8,704 isolates of N. gonorrhoeae were examined for their susceptibility to one or more antibiotics used for the treatment of gonorrhoea, incorporating External Quality Assurance controlled methods, from reporting centres in 21 countries and/or jurisdictions. A high proportion of penicillin and/or quinolone resistance was again detected amongst isolates tested in North Asia and the WHO SEAR. In contrast, from the Pacific Island states Fiji reported low penicillin and quinolone resistance, New Caledonia again reported no penicillin resistance and little quinolone resistance, Tonga reported no penicillin resistance and there was a continued absence of quinolone resistance reported in Papua New Guinea in 2009. The proportion of gonococci reported as 'decreased susceptibility' and 'resistant' to the third-generation cephalosporin antibiotic ceftriaxone varied widely but no major changes were evident in cephalosporin minimum inhibitory concentrations (MIC) patterns in 2009. Altered cephalosporin susceptibility has been associated with treatment failures following therapy with oral third-generation cephalosporins. There is a need for revision and clarification of some of the in vitro criteria that are currently used to categorise the clinical importance of gonococci with different ceftriaxone and oral cephalosporin MIC levels. The number of instances of spectinomycin resistance remained low. A high proportion of strains tested continued to exhibit high-level plasmid mediated resistance to tetracyclines. The continuing emergence and spread of antibiotic resistant gonococci in and from the WHO WPR and SEAR suggests that surveillance programs such as GASP be maintained and expanded.     

Sexually transmissible disorders in allochtonous population groups; a pilot study

In the registration of sexually transmitted diseases (STD) carried out by the nursing staff in the STD clinics the share of the immigrant populations of Turkish, Moroccan, Surinam and Antilles origin was investigated for the period 1986-89. In the total population of STD patients the immigrants appear to be overrepresented. Their share has increased from one-eight to one-fifth of the total number of STD cases. The STD rates (number of cases per 1000) for the Turkish and Moroccan populations are high, even after adjusting for population size and age. High STD rates are most apparent among males, especially among Turkish males. In comparison with the Dutch population more gonorrhoea is found among immigrants, in particular penicillinase producing Neisseria gonorrhoeae (PPNG). Turkish males (and prostitutes) contributed much to this relatively high prevalence. Further research is to be initiated in order to obtain better insight into the occurrence of STD among immigrant populations in The Netherlands, especially in connection with a potentially increased risk of infection with Human Immunodeficiency Virus (HIV).     

慈溪市2002-2008年性病流行特征分析

目的：分析慈溪市性传播疾病（STD）的流行特点,为制定性病防治策略提供科学依据。方法：对慈溪市2002-2008年法定报告的STD疫情进行描述流行病学分析。结果：累计报告STD 14 495例,淋病病例数最多,占总报告例数的43.51%;梅毒发病数逐年增加,构成比由2002年的10.07%上升到2008年的34.94%;男女性别比1.67∶1;职业以个体、农民为主,大多为20-39岁人群,文化程度偏低,以非婚性接触传染为主。结论：加强STD防治知识的宣传,普及健康性行为知识,推广使用安全套,提高自我保护意识,是控制STD蔓延的有效措施。     

2005-2019年中国538株脑膜炎奈瑟菌抗生素耐药性分析

目的:分析2005-2019年中国538株脑膜炎奈瑟菌抗生素耐药性特征。方法:收集中国2005-2019年30个省份538株脑膜炎奈瑟菌,参考临床和实验室标准化协会(CLSI)抗微生物药物敏感性试验执行标准,选用11种推荐抗生素,采用梯度扩散法检测脑膜炎奈瑟菌的抗生素敏感性。结果:538株脑膜炎奈瑟菌对阿奇霉素、美洛培南、氯霉素、利福平、头孢曲松等5种抗生素均敏感,无耐药菌株出现。对其他6种抗生素敏感性分别为:头孢噻肟(97.4%,524株)、氨苄西林(87.7%,472株)、青霉素(84.8%,456株)、米诺环素(95.2%,512株)、环丙沙星(24.9%,134株)、甲氧苄啶/磺胺甲基异噁唑(11.2%,60株)。结论:中国2005-2019年538株脑膜炎奈瑟菌对阿奇霉素、美洛培南、氯霉素、利福平、头孢曲松等5种抗生素均敏感,应关注对头孢噻肟、氨苄西林和青霉素等不敏感和耐药的菌株,不再推荐环丙沙星和磺胺甲基异噁唑作为临床救治和预防性服药首选药物。     

贵州省脑膜炎奈瑟菌药物敏感性检测及结果分析

目的了解贵州省脑膜炎奈瑟菌(Neisserid meningitides,Nm)的敏感性,为制定防控措施提供依据。方法采用纸片扩散法和Etest浓度梯度法对我省58株Nm进行12种抗菌药物的敏感性检测。结果 19株A群和16株B群Nm对四环素、青霉素、阿奇霉素、头孢曲松、头孢噻肟、氯霉素、利福平、美洛培南和氨苄西林均敏感,对复方新诺明、环丙沙星、左氧氟沙星都耐药。3株C群Nm中除1株对利福平不敏感外,其耐药菌谱与A和B群Nm的一致。而20株W135群Nm对青霉素、头孢曲松、氯霉素、美洛培南和氨苄西林敏感,对复方新诺明耐药,但对环丙沙星、四环素、左氧氟沙星、阿奇霉素、头孢噻肟和利福平表现出不同的耐药性特征。结论贵州省A、B、C、W135四个血清型的Nm对青霉素、头孢曲松、氯霉素、美洛培南和氨苄西林普遍敏感,对复方新诺明耐药。部分流脑菌株对一些抗生素具有耐药性,需全面监测病例和健康带菌者流脑菌株的耐药性特征。     

Venereal diseases among female alcoholics.

The incidence of gonorrhoea among 71 female alcoholics was studied from the twentieth year before, to the ninth year after the first compulsory treatment by the Temperance Board of Malm?. Twenty-five probands had, at some time, had gonorrhoea. The mean age at the first infection was high, over 28 years. None the less, the onset of gonorrhoea was an early "symptom". Recorded criminal offence, receipt of public assistance, and conviction for drunkenness usually appeared later. Each individual's risk of contracting gonorrhoea was assessed from tabulated data concerning the gonorrhoea incidence among Malm? women in general, specified by calendar year and age. A total of 53 infections was observed, as against 6.9 expected. The ratio of observed to expected gonorrhoea was not particularly high in the early period of observation. From the twelfth year before, up to one year before, the first compulsory treatment, the ratio increased to roughly fifteen to one. This high ratio remained during the subsequent years. Syphilis was diagnosed in five probands.     

Surveillance of antibiotic resistance in Neisseria gonorrhoeae in the WHO Western Pacific Region, 2004

The World Health Organization Western Pacific Region Gonococcal Antimicrobial Surveillance Programme (WHO WPR GASP) examined approximately 10,000 isolates of Neisseria gonorrhoeae from 15 countries for resistance to antibiotics in 2004. Treatment options for gonorrhoea in the Region are limited by persisting high rates of resistance to penicillins and quinolones. There were infrequent instances of spectinomycin resistance and the presence of gonococci with decreased susceptibility to third generation cephalosporins was again noted in several centres.