广州地区719株淋球菌对壮观霉素 环丙沙星的敏感性测定

目的 了解广州地区淋球菌对壮观霉素、环丙沙星的敏感性。方法 以琼脂稀释法测定719株淋球菌对壮观霉素、环丙沙星的最小抑菌浓度(MIC)。结果 壮观霉素MIC范围为2～128mg／L，MIC50和MIC90分别为16mg／L和32mg／L。719株淋球菌中有718株(99．86％)对壮观毒素敏感，6年间未发现耐药菌株。环丙沙星MIC范围0．002-32mg／L，3．06％菌株对环丙沙星敏感，22．95％为低度敏感，73．99％为耐药。结论 壮观霉素作为治疗淋病的一线药物对淋球菌临床分离株仍相当有效，氟喹诺酮类药物因高耐药率已不再适宜作为治疗淋球菌感染的首选药。     

广州地区淋球菌对环丙沙星耐药的监测与分析

目的 为了解广州地区1998～2002年淋球菌对环丙沙星敏感性和耐药性的变迁。方法 采用琼脂稀释法测定环丙沙星对每年分离的淋球菌的最低抑菌浓度(MIC)。结果 对1998～2002年在广州市性病监测中心就诊的性病患者中分离到的603株淋球菌，进行耐药性分析，环丙沙星的敏感率由1998年的12％降至2002年的零敏感，而耐药率由1998年的56．5％上升至2002年的98％。结论 广州地区流行的淋球菌的耐药情况日趋严重，喹诺酮类药物的高耐药率表明已不再适宜被推荐为治疗淋病的一线药物。有必要持续监测淋球菌的耐药性，并减少抗菌药物的滥用，以保证药物的敏感性。     

2007年南京地区淋球菌分离株对抗生素的敏感性测定

目的了解南京地区淋球菌对抗生素的敏感性,为淋病的防治提供科学依据。方法对202株来源于南京地区性病门诊患者的淋球菌进行了抗生素敏感性检测,用纸片酸度定量法测定β-内酰胺酶,并用琼脂稀释法测定大观霉素、环丙沙星、头孢曲松钠、四环素这4种抗生素的最小抑菌浓度。结果202株淋球菌中,产青霉素酶淋球菌（PPNG）的阳性率为35.64%,质粒介导的高度耐四环素淋球菌（TRNG）的阳性率为39.60%;所有菌株都对环丙沙星耐药,但未检出对大观霉素、头孢曲松钠耐药的菌株。结论推荐大观霉素和头孢曲松钠作为南京地区治疗淋病的首选药物,并应长期对淋球菌的耐药性进行监测。     

160例男性淋病奈瑟菌患者耐药情况分析

目的监测临床分离的淋病奈瑟菌对各种常见的抗菌药物的耐药性。方法采用临床实验室标准化研究所（CLSI）推荐的纸片扩散法,对从男性患者尿道分泌物中分离的160株淋病奈瑟菌的耐药性进行回顾性分析。结果 160株淋病奈瑟菌中对环丙沙星、四环素、青霉素、大观霉素、头孢曲松、头孢克肟、头孢哌酮/舒巴坦7种抗菌药物耐药情况,以环丙沙星、青霉素为主分别占6.3%、5.6%,其次是四环素占5.0%,头孢曲松和大观霉素占比例小均为0.6%,耐单药占比例最小为18.1%,联合耐药占比例最大为56.9%,多重耐药较单耐药高为25.0%。结论淋病奈瑟菌的耐药严重,联合耐药和多重耐药占比例大并且有逐年增加趋势,应引起临床医生的高度重视,制定合理的治疗方案,对降低细菌耐药率,有效控制疾病有重要意义。     

2000～2004年成都地区淋球菌耐药性监测

目的检测成都地区2000~2004年淋球菌耐药菌株的流行情况及变迁。方法用纸片酸度定量法测定β-内酰胺酶。用琼脂稀释法测定菌株对青霉毒、四环素、环丙沙星、大观霉素、头孢曲松钠等5种抗生素的最小抑菌浓度(MIC)。结果2000~2004年5年间,978株菌对青霉素和环丙沙星的耐药率分别为88.14%~99.08%和93.87%~99.44%,其MIC50、MIC90及MIC范围均无明显变化,均未发现敏感株;对头孢曲松敏感,2000~2004年未检出耐药株,其MIC50、MIC90及MIC范围有逐渐降低的趋势。5年来共检出13株耐大观霉素菌株;产β-内酰胺酶菌株(PPNG)和耐四环素淋球菌(TRNG)检出率分别为78.02%和57.57%,均高于同期全国其它城市。2004年PPNG的检出率高达91.93%,与前4年相比显著上升(χ2=37.16,P<0.005),TRNG检出率近2年比前3年略有下降(χ2=14.81,P<0.005)。结论成都地区淋球菌耐药情况非常严重,青霉素、四环素、环丙沙星已不能作为本地区治疗淋病的药物,推荐大观霉素和头孢曲松作为本地区治疗淋病的首选药物,应对淋球菌的耐药性进行长期监测。     

济宁地区淋球菌对抗生素的敏感性测定分析

目的了解济宁地区淋球菌对青霉素、环丙沙星、头孢曲松、壮观霉素的敏感性。方法用纸片法和稀释琼脂法测定药物敏感性，测定p内酰胺酶。结果壮观霉素及头孢曲松药物敏感性无明显变化，4年间未发现耐药菌株；环丙沙星耐药性显著上升，由2000年的59．0％上升至2003年的67．9％，PPNG菌株在4年内上升9．6％。结论PPNG菌株的明显上升和喹诺酮类药物的高耐药性，表明淋球菌的耐药趋势逐渐增强。在济宁地区壮观霉素和头孢曲松为治疗淋病的首选药物。     

2018-2021年天津地区淋病奈瑟菌耐药情况分析北大核心CSCD

目的 了解天津地区淋病奈瑟菌对抗生素的耐药情况,为治疗淋病提供实验室依据。方法 采用琼脂稀释法,对2018-2021年天津市收集到的308株淋病奈瑟菌临床分离株进行检测,测定其对青霉素、四环素、环丙沙星、头孢曲松、大观霉素、阿奇霉素6种抗生素的最低抑菌浓度(MIC),并判断其耐药性。结果 308株淋病奈瑟菌,其中产青霉素酶的淋病奈瑟菌株(PPNG)占36.69%(113株)、质粒介导的高度耐四环素淋病奈瑟菌株(TRNG)占24.68%(76株)。环丙沙星耐药率高达99.03%(305株),青霉素耐药率81.17%(250株),阿奇霉素耐药率25.97%(80株),四环素耐药率24.68%(76株),未发现对大观霉素和头孢曲松耐药的菌株;发现32株(10.39%)对阿奇霉素耐药同时对头孢曲松中敏的淋病奈瑟菌。全基因测序一株淋病奈瑟菌,发现22个与耐药相关的基因。结论 大观霉素和头孢曲松为主的一线治疗药物,适合天津现阶段淋病的临床治疗,但是仍需要长期监测耐药性变化。     

淋球菌耐药基因研究进展

耐药性(resistance)是指病原微生物对药物产生的对抗性。耐药性可以分为交叉耐用药性和多重耐药性,分别是指病原微生物对作用机制相同及作用机制不同的多种抗菌药物产生的耐药性。近年来,随着淋病的不断广泛流行和新的抗生素在临床上的广泛使用,淋病的病原体-奈瑟氏淋球菌(Neisseria Gonorrhoeae)的耐药性也不断发生变化,并且有逐年增加的趋势。在WHO对西太平洋地区开展的淋球菌耐药性监测(ASP GonococcalAntimicrobial Surveillance Programme)中发现在西     

淋病奈瑟氏菌的耐药性及耐药质粒的研究现状

淋病是我国目前最常见的性传播疾病之一。随着抗生素的广泛使用,淋病奈瑟氏菌的耐药性也越来越严重。该文就淋病奈瑟氏菌的耐药现状、耐药质粒的研究进展做出综述。显示：淋病奈瑟氏菌的耐药除可由染色体介导外,更主要是由质粒介导;研究较多的质粒携带的耐药基因是TEM-1基因和TetM基因;常用核酸杂交法和聚合酶链反应进行耐药基因的检测。     

淋球菌耐药现状及新药研究进展

淋病是由淋病奈瑟球菌感染引起的性传播疾病,属于我国法定乙类传染病。近年来,由于抗菌药物广泛、不合理的使用,导致淋球菌发生变异,使多种抗生素失效,且多重耐药菌株逐渐增多,为淋病的防治带来巨大挑战。继青霉素、四环素及喹诺酮类药物后,联合用药方案又受到阿奇霉素耐药的威胁。目前,大观霉素和头孢曲松为一线推荐治疗药物,但已分离到头孢曲松及大观霉素耐药菌株。此外,尚无有效疫苗用于淋球菌的防治。因此,高效、廉价的新药的研发迫在眉睫。本文系统综述淋球菌的流行现状、耐药现状,重点关注淋病治疗新药研究进展。     

淋病奈瑟菌常见抗生素耐药机制的研究进展

淋病奈瑟菌是淋病的病原菌。淋病目前在我国性传播疾病中感染率较高,有效的抗生素治疗是防治淋病的主要方法,但淋病奈瑟菌可通过改变作用靶点、改变对细胞膜的通透性、产生抗生素灭活酶以及药物外排机制等方式降低对抗生素的易感性。为了更好地指导临床用药、对淋病进行预防和防治,需要严密监测淋病奈瑟菌的耐药情况。本文针对淋病奈瑟菌常见抗生素的耐药机制进行综述。     

对淋球菌进行壮观霉素的敏感性测定

为了解淋球菌对壮观霉素的敏感性，我们对近８年来由１０个城市性病门诊患者分离的１６３１株淋球菌进行了壮观霉素体外敏感性试验。以琼脂稀释法测定壮观霉素的最小抑菌浓度（ＭＩＣ）。壮观霉素ＭＩＣ范围为２～＞１２８ｍｇ／Ｌ。ＭＩＣ５０和ＭＩＣ９０分别为１６ｍｇ／Ｌ和３２ｍｇ／Ｌ。１６３１株淋球菌中有１６２２株（９９．４５％）对壮观霉素敏感，ＭＩＣ达１２８ｍｇ／Ｌ的耐药菌株仅占０．５５％。研究表明，壮观霉素作为治疗淋病的一线药物对我国目前流行的淋球菌分离株仍相当有效。     

DNA gyrase gene in Neisseria gonorrhoeae as indicator for resistance to ciprofloxacin and species verification

We have identified a unique region of eight amino acids in the quinolone resistance-determining region in the gyrA gene in Neisseria gonorrhoeae as an indicator of resistance to fluoroquinolones. We sequenced that region by the Pyrosequencing technology in 46 N. gonorrhoeae strains and 11 urine samples positive in AMPLICOR N. gonorrhoeae polymerase chain reaction (Roche Diagnostics), with corresponding isolates of N. gonorrhoeae. The results showed that 28 samples with minimum inhibitory concentration (MIC) of ciprofloxacin >1 mg/L had mutations in positions 91 and 95. Fifteen samples with MIC 0.125-1.0 mg/L had either one or both of the mutations. The 14 susceptible samples had no mutations. The target region also discriminates N. gonorrhoeae from other species of Neisseria. Our conclusion is that gyrA is an indicator of resistance to ciprofloxacin in N. gonorrhoeae and sequencing by Pyrosequencing technology is a suitable tool for analysis of DNA in urine samples.     

Prevalence of antimicrobial resistance in Neisseria gonorrhoeae in an HIV/AIDS clinic

Antimicrobial resistance in Neisseria gonorrhoeae is increasing in the Pacific region. The standard antibiotic used in urban Australia is intramuscular ceftriaxone. Isolates with reduced sensitivity are being isolated; however, resistance to ceftriaxone has yet to occur. Continued surveillance of antimicrobial resistance in the pathogen, with communication between clinic and laboratory, is needed to ensure optimal treatment of infection.     

Neisseria gonorrhoeae in a London sexually transmitted infection clinic not fully sensitive to quinolones: are isolates imported and how effective is ciprofloxacin as a first-line therapy?

Our objectives were to determine the prevalence of Neisseria gonorrhoeae not fully sensitive to ciprofloxacin from a sexually transmitted infection (STI) clinic in London and where the isolates were acquired from. Data of antibiotic sensitivities of N. gonorrhoeae from 292 patients were reviewed over a 6-month period at St Mary's Genitourinary Medicine (GUM) Clinic, London. Isolates which exhibited reduced susceptibility (minimum inhibitory concentration [MIC] 0.03-0.12 mg/l) and high level resistance (MIC>0.12 mg/l) to ciprofloxacin represented 10% and 1.3% of the total respectively. All patients infected with a high level resistant isolate to ciprofloxacin had had a recent sexual partner from abroad but 18 of the 28 patients infected with a reduced susceptibility isolate denied recent travel. None of the 20 patients with a non-sensitive isolate who re-attended for post treatment cultures had persistant gonococcal infection. From this study we concluded that although N. gonorrhoeae resistant to ciprofloxacin was rare and probably always acquired abroad, isolates exhibiting reduced susceptibility were more common and were mainly as a result of infection from the UK. A stat dose of ciprofloxacin 500 mg and doxycycline 100 mg twice a day for one week was effective treatment.     

One year of Neisseria gonorrhoeae isolates in Sweden: the prevalence study of antibiotic susceptibility shows relation to the geographic area of exposure

The aim of this study was to compare epidemiological data with antibiotic susceptibility patterns, so as to characterize the risk of infection with a highly resistant Neisseria gonorrhoeae strain. N. gonorrhoeae strains isolated in Sweden from February 1998 through January 1999 were tested for antibiotic susceptibility. Epidemiological data were received from each clinician reporting a case of gonorrhoea and these data were linked to the N. gonorrhoeae strains. A total of 348 N. gonorrhoeae isolates, representing 89% of all Swedish cases diagnosed during the 12-month period, were tested for antibiotic susceptibility. Of all isolates, 24% were beta-lactamase-producing, and 18% had decreased susceptibility to ciprofloxacin (MIC>0.064 mg/l). All isolates were fully susceptible to ceftriaxone and spectinomycin. More than 99% of the isolates were fully susceptible to azithromycin. The antibiotic susceptibility varied with the places where patients were exposed to infection. When exposed in Asia, 63% of the isolates showed reduced susceptibility to ciprofloxacin, compared with 0-8.5% of the isolates from patients exposed in other places (RR=8.5, P<0.001). Ciprofloxacin cannot be recommended as the first choice of treatment if the place of exposure was in Asia.     

Antimicrobial resistance pattern of Neisseria gonorrhoeae isolates from peripheral health centres and STD clinic attendees of a tertiary care centre in India

The aim of the study was to compare the antimicrobial resistance pattern of Neisseria gonorrhoeae isolates from urban and rural peripheral health centres and from sexually transmitted disease (STD) clinic attendees. Antimicrobial susceptibility testing of 191 N. gonorrhoeae isolates (165 isolates from STD clinic attendees and 26 from peripheral health centres) was carried out in Delhi, India, using the calibrated dichotomous sensitivity technique for penicillin, tetracycline, ceftriaxone, ciprofloxacin, spectinomycin and nalidixic acid, and minimum inhibitory concentrations were determined using E-test. Penicillin-resistant, ciprofloxacin-resistant, penicillinase-producing N. gonorrhoeae and tetracycline-resistant N. gonorrhoeae strains were higher in STD clinic attendees than in peripheral health centres, probably because of less antibiotic pressure in the peripheral areas. High-level resistance to ciprofloxacin and multiresistant strains were also higher in STD clinic attendees. The present study emphasizes the importance of surveillance of antimicrobial resistance of N. gonorrhoeae in different population subgroups in order to monitor the spread of multiresistant strains and to update the national treatment recommendations.     

Antimicrobial susceptibility of Neisseria gonorrhoeae strains isolated in Nuuk,Greenland during 1998-1999

Sixty-one gonococcal strains isolated in Greenland during 1998-1999 were tested locally for susceptibility to penicillin and ciprofloxacin by a disc diffusion method (Rosco) and at the reference laboratory in Copenhagen by the agar dilution method and the E-test, showed that more than 60% of the strains were less susceptible or resistant to penicillin (minimum inhibitory concentration [MIC] > or = 0.25 mg/L), indicating that penicillin should not be used as a first line drug for the treatment of gonorrhoea in Greenland. The Rosco disc diffusion method only identified 8% of strains as less susceptible to penicillin. Ciprofloxacin can still be used as a first line drug for treatment of gonorrhoea in Greenland since decreased susceptibility was only seen in one imported strain. However, the decreased susceptibility in this strain was not identified by the Rosco disc diffusion test, therefore the future local surveillance of antibiotic resistance in Neisseria gonorrhoeae will be based on MIC determinations.     

Increased ciprofloxacin resistance in gonococci isolated in Scotland

A review of the susceptibility of Neisseria gonorrhoeae isolated from 4415 episodes of infection in Scotland between 1991 and 1999 showed that the proportion of isolates with lowered susceptibility (ciprofloxacin minimum inhibitory concentration [MIC] > or = 0.05 mg/L) increased from 0.5% in 1991 to 5% in 1999 (p<0.001), whereas the proportion of isolates with clinical resistance (ciprofloxacin MIC > or = 1 mg/L) was significantly higher in 1999 than the average for the preceding 4 years (2.2% vs 0.9%; p=0.02). Ciprofloxacin is a recommended treatment for gonococcal infection in the UK but if resistance continues to increase at the present rate it might not be suitable as a first-line treatment of gonorrhoea for much longer.