中国1993～2000年分离淋球菌的流行病学和细菌学特征

目的：研究中国1993-2000年分离的淋球菌对青霉素、四环素、环丙沙星、大观霉素和头孢曲松的敏感性及其营养分型和携带质粒情况，为制订淋病治疗方案和防治对策的参考依据。方法：用琼脂稀释法测定菌株对抗菌药物的敏感性，用改良Catline法和碱裂解法测定菌株的营养分型和携带耐药质粒的情况。结果：8年来共检测了4976株淋球菌对抗生素的敏感性，发现对青霉素耐药率为71.60％，产青霉素酶淋球菌（PPNG）菌株占15.54；对四环素的耐药菌株占93.02％，由质粒介导的高度耐四环素淋球菌（TRNG）菌株占10.48％；环丙沙星的耐药菌株占53.30％；对大观霉素和头孢曲松的耐药菌株分别占0.36％和0.46％。1995年和1996年南京地区菌株的营养分型原型（proto）占46.4％和47.53％，脯氨酸（pro^-）型占48.4％和50.22％。对40株淋球菌作了质粒分型：30株非PPNG菌株中，2株（15％）不含任何质粒；28株含有4.2kb、4.9kb、5.4kb和39.5kb质粒；10株PPNG株和非PPNG株所含有的5.4kb质粒虽分子量相近，但酶切点不尽相同。结论：1993-2000年分离的淋球菌对青霉素、四环素和环丙沙星耐药率较高，对大观霉素和头孢曲松仍较敏感。南京地区1995-1996年流行的淋球菌的营养分型我大变化。含5.4kb质粒的PPNG和非PPNG菌株所含核苷酸的排列顺序可能有所不同。

Epidemiological and bacteriological characteristics of Neisseria gonorrhoeae isolates in China

Objective To investigate the antimicrobial susceptibility,auxotype, and plasmid profile of Neisseria gonorrhoeae isolates in China and to provide evidence for the development of treatment guideline and policy for control. Methods Agar dilution was used to detect antimicrobial susceptibility. The auxotype was determined by GC genetic medium. The plasmid was extracted by aklaline cleavage and electrophresed. Results A total of 4 976 gonococcal isolates were tested in the last 8 years. The resistant rate for penicillin was 71.60 % with PPNG being 15.54 %. Tetracycline resistant (TRNG) isolates accounted for 93.02 % with 10.48 % high level tetracycline resistant. The resistant rate for ciprofloxacin was also relatively high ( 31.78 %). The resistant rates for spectinomycin and ceftriaxone were 0.36 % and 0.46 %. The predominant auxotypes of gonococcal isolates were proto and pro - during 1995 1996 in Nanjing,accounted for 46.4 % and 47.53 %, 48.4 % and 50.22 %, respectively. There were 8 strains harboring 4.2 , 5.4 , 39.5 kb plasmids and 2 harboring 4.2 , 4.9 , 5.4 , 39.5 kb plasmids in 10 PPNG strains; 2 harboring no pasmid, 28 harboring 4.2 , 4.9 , 5.4 , 39.5 kb plasmids in 30 non PPNG strains. The 5.4 kb plasmid of PPNG could be digested with restriction endonuclease BamHI while the 5.4 kb plasmid of non PPNG could not. Conclusion The gonococcal isolates were highly resistant to penicillin, tetracycline, and ciprofloxacin, while were still sensitive to spectinomycin and ceftriaxone. No significant auxotyping change was found in terms of predominant gonococcal strains in the last two years in Nanjing while 5.4kb plasmid might be the most prevalent resistant plasmid in Nanjing.