1999-2002年南京地区淋球菌分离株抗生素敏感性监测

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。     

淋球菌流行株对阿奇霉素等7种抗菌药物敏感性的检测

目的:检测2013年度本地区临床分离的淋球菌流行株对青霉素、四环素、大观霉素、头孢曲松、环丙沙星、头孢克肟和阿奇霉素等7种抗菌药物的敏感性,分析耐药菌株的流行特点。方法:采用琼脂稀释法测定85株菌株对7种抗菌药物的最小抑菌浓度(MIC),判断敏感性按WHO西太平洋区淋球菌耐药性监测统一标准。用纸片酸度法检测产β-内酰胺酶淋球菌(PPNG)菌株。结果:85株淋球菌中检出68株对青霉素耐药(80%),产β-内酰胺酶淋球菌(PPNG)32株(37.6%);四环素耐药率为84.7%,其中质粒介导高度耐四环素淋球菌(TRNG)34株,占40%;环丙沙星和阿奇霉素的耐药率分别为97.6%和3.5%。未发现对头孢曲松、头孢克肟、大观霉素耐药菌株,但头孢曲松和头孢克肟敏感性降低的菌株分别为16.5%和5.9%。青霉素、四环素和环丙沙星的MIC50及MIC90均已超过耐药标准,青霉素和四环素MIC50及MIC90均大于耐药标准的32倍。结论: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、头孢曲松和头孢克肟的敏感性较高,出现阿奇霉素的耐药株。     

2000年上海地区淋球菌对抗生素的敏感性测定

为了解上海地区淋球菌对抗生素的敏感性，2000年我们从上海地区分离出225株淋球菌流行株，使用琼脂平皿稀释法测定青霉素、四环素、头孢曲松、大观霉素、环丙沙星对淋巴菌的最小抑菌浓度（MIC),采用纸片法对菌株作β－内酰胺酶测定。结果：225株淋球菌中产青霉素酶株（PPNG）84株（37．32％），质粒介导高度耐四环素株（TRNG）15株（6．67％），环丙沙星高度耐药株（MIC≥16mg/L）22株（9．33％），朱发现对头孢曲松、大观霉素耐药菌株。对淋球菌进行持续的耐药监测，有助于了解流行菌株的耐药情况，为制定防治策略提供依据。上海地区宜首选大观霉素或头孢曲松治疗淋球菌感染。     

淋球菌流行株抗生素敏感性监测

目的：监测广州地区2007年度分离的淋球菌对青霉素、四环素、大观霉素、头孢曲松和环丙沙星的敏感性，分析耐药菌株的流行特点。方法：采用琼脂稀释法测定菌株对5种抗生素的最小抑菌浓度（MIC），判断敏感性按WHO西太区淋球菌耐药性监测统一标准。用纸片酸度法检测产β-内酰胺酶淋球菌（PPNG）菌株。结果：123株淋球菌中检出115株对青霉素耐药（93，5％），产β-内酰胺酶淋球菌（PPNG）39株（占31．7％）；四环素耐药率为87％，其中质粒介导高度耐四环素淋球菌（TRNG）为72株，占58、5％；环丙沙星耐药率为91，1％；未发现对大观霉素和头孢曲松耐药菌株。青霉素、四环素和环丙沙星的MIC50及MIC90均已超过耐药标准，尤以青霉素为甚，其MIC508及MIC90均超过耐药标准的8倍和大于32倍。结论：淋球菌对大观霉素和头孢曲松的敏感性较高，可作为治疗的首选药物，对青霉素、四环素和环丙沙星耐药率较高，提示对淋病的治疗作用差。     

广东省汕头市92株淋球菌药物敏感性检测

目的：了解汕头地区2009年淋球菌对多种抗菌药物耐药的发生率及产β-内酰胺酶淋球菌（PPNG）和四环素高度耐药淋球菌（TRNG）的流行状况.方法：采用琼脂稀释法测定5种抗菌药物最低抑菌浓度（MIC）,纸片酸度法测定青霉素产β-内酰胺酶菌株.结果：92株淋球菌对青霉素耐药率为84.8%、四环素耐药率为89.1%、环丙沙星耐药率为92.4%;未发现大观霉素及头孢曲松耐药菌株.检出PPNG高达31株（33.7%）.TRNG为47株（51.1%）.青霉素﹑四环素和环丙沙星的MIC50及MIC90均已超过耐药标准.结论：大观霉素和头孢曲松为汕头地区治疗淋病的首选药物.     

珠海地区淋球菌对抗生素的耐药性分析

目的:了解珠海地区2010年度分离的淋球菌对青霉素、四环素、大观霉素、头孢曲松和环丙沙星的耐药性,分析产β-内酰胺酶淋球菌(PPNG)和四环素高度耐药淋球菌(TRNG)的流行状况。方法:采用琼脂稀释法测定菌株对5种抗生素的最小抑菌浓度(MIC);用纸片酸度法检测产β-内酰胺酶(PPNG)菌株。结果:105株淋球菌检出PPNG 33株(31.4%),TRNG 51株(48.6%);青霉素耐药率为60.1%,环丙沙星耐药率为100%,四环素耐药率为93.3%,其中同时对青霉素、四环素和环丙沙星三重耐药的有62株(59.1%);未发现大观霉素和头孢曲松耐药株,敏感性分别为100%和62.9%。结论:淋球菌对青霉素、四环素和环丙沙星的耐药率较高,壮观霉素和头孢曲松为珠海地区治疗淋病的首选药物。     

2001～2006年福州地区淋球菌耐药监测结果

为研究福州地区2001~2006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,制定治疗方案和防治对策的参考依据,共监测了1206株淋球菌对抗菌药物的敏感性,测定菌株对抗菌药物的敏感性用琼脂稀释法,测定产青霉素酶淋球菌菌株用纸片酸度法。发现产青霉素酶的菌株(PPNG)258株,占21.39%。质粒介导的高度耐四环素菌株(TRNG)260株占21.56%。本地区PPNG菌株及质粒介导的高度耐四环素菌株呈明显上升趋势。环丙沙星耐药1163株占96.43%。淋球菌对大观霉素和头孢曲松仍较敏感。     

珠海地区淋球菌对抗生素的耐药性分析

目的:了解珠海地区2010年度分离的淋球菌对青霉素、四环素、大观霉素、头孢曲松和环丙沙星的耐药性,分析产β-内酰胺酶淋球菌(PPNG)和四环素高度耐药淋球菌(TRNG)的流行状况.方法:采用琼脂稀释法测定菌株对5种抗生素的最小抑菌浓度(MIC);用纸片酸度法检测产β-内酰胺酶(PPNG)菌株.结果:105株淋球菌检出PPNG 33株(31 4%),TRNG 51株(48 6%);青霉素耐药率为60 1%,环丙沙星耐药率为100%,四环素耐药率为93 3%,其中同时对青霉素、四环素和环丙沙星三重耐药的有62株(59 1%);未发现大观霉素和头孢曲松耐药株,敏感性分别为100%和62 9%.结论:淋球菌对青霉素、四环素和环丙沙星的耐药率较高,壮观霉素和头孢曲松为珠海地区治疗淋病的首选药物.     

微量稀释法检测淋球菌流行株药敏试验结果分析

 目的:对2016年10月-2018年6月我院收集的淋球菌流行株进行耐药性监测，了解本院淋球菌耐药情况。方法:采用微量稀释法测定淋球菌对青霉素、四环素、环丙沙星、大观霉素、头孢曲松、头孢克肟和阿奇霉素最低抑菌浓度（MIC），根据世界卫生组织（WHO）标准判读结果，用纸片酸度法测定产β 内酰胺酶淋球菌菌株（PPNG）。结果:共检测95株淋球菌流行株，对青霉素、四环素、环丙沙星和阿奇霉素的耐药率分别为75.79%、86.32%、91.58%和14.74%，青霉素、四环素和环丙沙星的MIC50均已超过耐药标准，未检出对大观霉素、头孢曲松和头孢克肟耐药菌株，头孢曲松和头孢克肟的低敏率分别为5.26%和9.47%。PPNG和四环素高度耐药淋球菌（TRNG）流行率为33.68%和36.84%。结论:青霉素、四环素、环丙沙星耐药率高，已不适用于淋病的治疗；大观霉素、头孢曲松、头孢克肟敏感性高，可作为治疗淋病的一线药物。持续监测淋球菌耐药性发展趋势对指导临床合理用药具有重大意义。     

2003～2006年南京地区淋球菌分离株抗菌药物敏感性监测

目的：分析2003～2006年淋球菌耐药现状。方法：纸片酸度定量法测定菌株的β-内酰胺酶;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：共检测了791株淋球菌,产青霉素酶淋球菌（PPNG）的阳性率每年维持在42.23%～57.36%之间,质粒介导的耐四环素淋球菌（TRNG）的阳性率由2003年的19.47%（37/190）上升到2006年的32.82%（65/198）。在非PPNG中,染色体介导的青霉素耐药菌株的阳性率介于57.84%～87.27%。耐环丙沙星淋球菌的阳性率介于97.89%～99.51%,未检出头孢曲松耐药菌株,每年的低敏菌株比例处于30.58%～57.89%之间。每年均检出1～2株大观霉素耐药菌株,共6株。结论：头孢曲松和大观霉素为治疗淋病的有效药物。     

淋球菌130株对7种抗生素的耐药性结果分析

目的了解2018年本单位淋球菌对7种抗生素耐药趋势及产青霉素酶淋球菌(PPNG)和质粒介导的高度耐四环素淋球菌(TRNG)流行情况。方法琼脂稀释法测定青霉素、四环素、环丙沙星、大观霉素、阿奇霉素、头孢曲松、头孢克肟的最低抑菌浓度(MIC),根据世界卫生组织(WHO)的标准判定其敏感性;用纸片碘量法检测β-内酰胺酶。结果 130株淋球菌检出PPNG达43.85%(57/130),(TRNG)达22.31%(29/130),环丙沙星耐药率高达96.92%(126/130),阿奇霉素耐药率达16.15%(21/130),大观霉素未发现耐药菌,头孢曲松、头孢克肟敏感率都是90.77%(118/130),中度敏感率达9.23%(12/130)。结论头孢曲松、头孢克肟、大观霉素都未见耐药菌株,仍可推荐为广州地区淋病患者首选药物,但前二者中度敏感率呈动态变化,提示临床应长期监测耐药性动态变化的重要性。     

西安地区2002-2009年淋球菌耐药性趋势分析

目的 监测西安地区淋球菌对抗生素的耐药性及产青霉素酶(PPNG)和质粒介导的耐四环素菌株(TRNG),了解淋球菌耐药趋势.方法 2002-2009年从性病门诊确诊的淋病患者中分离647株淋球菌.采用琼脂稀释法检测菌株是否为TRNG及对抗生素最低抑菌浓度(MIC),采用纸片酸度法测定菌株是否产β-内酰胺酶(PPNG).结果 647株淋球菌中,检出216株(33.4%)TRNG,PPNG为290株(44.8%).TRNG的阳性率保持在28.3%～49.2%,只有2005年阳性率是17.3%.PPNG阳性率由2002年的37.1%上升到2005年的64%,呈递增趋势,但2006-2009年又逐年下降,2009年下降到32.3%.大观霉素的耐药率为0～2.8%.环丙沙星的耐药率除2006年(51%)有所下降以外,其余均在80%以上,2005年达到100%.头孢曲松的耐药率除2003年发现4株耐药外,其余无耐药株出现,但敏感菌株逐渐减少,中敏菌株逐年递增.结论 淋球菌对大观霉素敏感性高,应做为治疗淋病的首选药物,头孢曲松治疗淋病应注意给足剂量,环丙沙星不能做为治疗淋病用药.

Abstract：

Objective To monitor the antibiotic resistance in Neisseria gonorrhoeae, determine the prevalence of penicillinase-producing Neisseria gonorrhoeae (PPNG) and plasmid-mediated tetracycline-resistant Neisseria gonorrhoeae (TRNG) in Xi'an region, and to analyse the trends in antibiotic resistance in Neisseria gonorrhoeae. Methods In total, 647 strains of Neisseria gonorrhoeae were isolated from patients with gonorrhea in sexually transmitted disease (STD) clinic settings from 2002 to 2009. Agar dilution method was used to detect TRNG and determine the minimal inhibitory concentration (MIC) of antibiotics, and paper acidometric method to detect PPNG. Results Of these 647 strains, 216 (33.4%) were TRNG, 290 (44.8%)were PPNG. The prevalence of TRNG strains remained between 28.3% and 49.2% in 2002-2009, except for 17.3% in 2005; the prevalence of PPNG strains increased from 37.1% in 2002 to 64% in 2005, but declined from 2006 to 2009 (32.3%). The prevalence of resistance to spectinomycin maintained at a low level (0 to 2.8%) over these years, while that to ciprofloxacin remained higher than 80% from 2002 to 2009, and accounted for 100% in 2005, with the exception of 51% in 2006. Ceftriaxone resistance was observed in none of these strains except 4 isolates in 2003, but the susceptibility to ceftriaxone decreased yearly. Conclusions Neisseria gonorrhoeae is highly sensitive to spectinomycin, which should serve as the first treatment choice for gonorrhea.Full dose is necessary for the application of ceftriaxone in the treatment of gonorrhea. Ciprofloxacin should not be used to treat gonorrhea.     

100株淋球菌对7种抗生素的耐药性结果分析

 目的:监测2019年本单位淋球菌对7种抗生素的耐药性趋势及产青霉素酶淋球菌(PPNG)和质粒介导的高度耐四环素淋球菌(TRNG)流行情况,为临床有效选择抗生素提供实验室依据。方法：收集本单位门诊临床分离培养的100株淋球菌,用琼脂稀释法测定青霉素、四环素、环丙沙星、大观霉素、阿奇霉素、头孢曲松、头孢克肟的最低抑菌浓度（MIC）;用纸片碘量法检测β 内酰胺酶。结果：产青霉素酶淋球菌（PPNG）株占35％（35/100）,质粒介导的高度耐四环素淋球菌（TRNG）株占32％（32/100）。环丙沙星和青霉素的耐药率分别高达99％（99/100）、93%（93/100）。阿奇霉素耐药率达10%（10/100）。头孢曲松和头孢克肟未见耐药菌株,低敏率分别为22%（22/100）和19%（19/100）,敏感率分别为78%（78/100）和81%（81/100）。大观霉素未发现耐药菌株和低敏菌株。结论：头孢曲松、头孢克肟、大观霉素仍可推荐为广州地区淋病患者首选药物。建议临床制定合理抗菌治疗方案以提供科学指导时,应长期监测淋球菌耐药性。     

1993～ 1998年中国十城市分离的淋球菌对抗生素的敏感性监测

目的 研究我国1993－1998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,作为制定治疗方案和防治对策的参考依据。方法 测定菌株对抗生素的敏感性用琼脂稀释法,测定产霉素酶淋球菌菌株用纸片酸度法。结果 6年来,共检测了3186株淋球菌对抗生素的敏感性。发现青霉素的耐药菌百分率为66．70％,产青霉素酶淋球菌菌株占8．14％;对四环素的耐药菌株占93．02％,高度耐药的四环素耐药淋球菌菌株占4．65％。结论 我国近6年分离的淋球菌对青霉素、四环素和环丙沙星耐经菌百分率较高,对大观霉素和头孢曲松仍较敏感。     

Antimicrobial susceptibility of Neisseria gonorrhoeae isolates from a military population in San Diego

Neisseria gonorrhoeae isolates were studied to determine their patterns of antimicrobial susceptibility and possible chemotherapeutic implications. Of 370 consecutive isolates, 32 (8.7%) were penicillinase-producing N. gonorrhoeae (PPNG). The remaining 338 were subjected to disk-diffusion tests, and those apparently resistant to penicillin, tetracycline, or spectinomycin were tested by an agar-dilution method. The dilution test showed that 5.4% (20/370) were penicillin-resistant, non-PPNG strains, of which 100%, 90%, and 45% were also resistant to tetracycline, cefoxitin, and erythromycin, respectively. No resistance to spectinomycin or ceftriaxone was demonstrated, although there was an association between minimum inhibitor concentrations (MICs) of penicillin of greater than or equal to 1.0 microgram/ml and increased MICs of ceftriaxone. The overall incidence of penicillin resistant isolates, including PPNG, was 14.1% (52/370). Of the 20 penicillin-resistant, non-PPNG strains, all were also resistant to tetracycline, and another 21 exhibited tetracycline resistance but were sensitive to penicillin. The in-vitro data suggested that: (1) neither penicillin, tetracycline, nor cefoxitin were acceptable drugs for routine treatment of gonorrhea in our population during the study period; (2) spectinomycin and ceftriaxone continue to demonstrate adequate in-vitro activity against N. gonorrhoeae despite increasing in-vitro resistance to penicillin; and (3) non-plasmid-mediated resistance to penicillin may predict future resistance to ceftriaxone.     

淋球菌对头孢克肟等6种抗生素敏感性及耐药质粒分型研究

目的:检测2011年广东省广州、佛山、江门、肇庆四市临床分离的淋球菌流行株对青霉素、四环素、环丙沙星、头孢克肟、头孢曲松和大观霉素等6种抗生素的敏感性,对质粒介导的产β-内酰胺酶淋球菌(PPNG)和四环素高水平耐药淋球菌(TRNG)进行耐药质粒TEM-1和tetM基因分型。方法:采用琼脂稀释法测定菌株对6种抗菌药物的最小抑菌浓度(MIC),判断敏感性按WHO西太区淋球菌耐药性监测统一标准,其中头孢克肟敏感性试验和判断标准按美国临床和实验室标准化研究所(CLSI)判断。用纸片酸度法检测产β-内酰胺酶淋球菌(PPNG)菌株,多重PCR方法鉴定β-内酰胺酶质粒并进行TEM-1和TRNG tetM基因分型。结果:来自四市429株淋球菌中检出青霉素耐药364株(84.8%),四环素和环丙沙星耐药株(率)分别为389株(90.7%)和418株(97.4%),未发现对大观霉素、头孢克肟和头孢曲松耐药菌株,但头孢曲松低敏率达到34.0%(146/429),头孢克肟低敏只有1株(0.2%)。青霉素、四环素和环丙沙星的MIC50及MIC90均已超过耐药标准。检出PPNG株156株(36.4%),TRNG株201株(46.9%)。耐药质粒TEM-1基因分型以亚洲型为主(94.9%,148/156),只有8株携带非洲型质粒;tetM基因分型均为荷兰型。结论:四市淋球菌对青霉素、四环素和环丙沙星耐药率较高,对大观霉素、头孢克肟和头孢曲松的敏感性较高,TEM-1基因质粒分型以亚洲型为主,tetM基因分型均为荷兰型。     

南宁地区2009-2011年淋球菌抗生素耐药性的检测结果分析

目的了解淋球菌对5种抗生素的耐药情况,为制定淋病合理有效的治疗方案提供理论依据。方法对2009-2011年广西南宁地区分离的96株淋球菌,在系统鉴定的基础上,根据世界卫生组织(WHO)标准判定其敏感、中度敏感及耐药。结果 96株淋球菌中β-内酰胺酶(+)菌株为28株;质粒介导的高度耐四环素淋球菌TRNG(+)57株。环丙沙星耐药率为98.96%。头孢曲松和大观霉素未发现耐药菌株。结论南宁地区淋球菌耐药以环丙沙星为甚,四环素和青霉素次之。     

Surveillance of antimicrobial susceptibilities in Neisseria gonorrhoeae in Nanjing, China, 1999-2006

OBJECTIVE: To monitor the frequency and types of antibiotic resistance of Neisseria gonorrhoeae in Nanjing, China, between 1999 and 2006. METHODS: beta-Lactamase production was determined by paper acidometric testing. Minimum inhibitory concentrations (MICs) to penicillin, ceftriaxone, tetracycline, ciprofloxacin, and spectinomycin were determined by agar plate dilution. Plasmid types were determined for TRNG and PPNG isolates by PCR. RESULTS: One-thousand two-hundred and eight N. gonorrhoeae isolates were examined. The rate of PPNG rose from 8.0% (9 of 112) in 1999 to 57.36% (113 of 197) in 2004, and declined to 44.44% (88 of 198) in 2006. Prevalence of TRNG increased from 1.8% (2 of 112) in 1999 to 32.82% (65 of 198) in 2006. 99.23% (258 of 260) of TRNG contained the Dutch-type tetM gene and 2 strains contained the American-type tetM gene. All PPNG examined contained the Asian type plasmid. Among non-PPNG, chromosomally mediated resistance to penicillin varied from 57.84% (59 of 102) to 87.80% (72 of 82). Chromosomal resistance to ciprofloxacin (QRNG) was detected in 83.93% (94 of 112) of the strains in 1999 and 98.99% (196 of 198) in 2006. Eight spectinomycin-resistant N. gonorrhoeae strains were detected between 2001 and 2006. None of the gonococcal isolates tested was resistant to ceftriaxone but decreased susceptibility was observed in some strains. CONCLUSIONS: Among N. gonorrhoeae strains isolated in Nanjing, China, plasmid mediated resistance including PPNG and TRNG increased significantly between 1999 and 2006. Chromosomally mediated resistance to both penicillin and ciprofloxacin was also high during this period. Spectinomycin resistance of N. gonorrhoeae was sporadic. Ceftriaxone and spectinomycin can be considered effective antimicrobial agents for the treatment of gonorrhea in Nanjing at the present time.