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。     

上海地区淋球菌临床分离株对不同抗生素的敏感性分析

目的了解上海地区淋球菌临床分离株对抗生素的敏感性。方法收集临床淋球菌80株,采用琼脂平皿稀释法测定青霉素、头孢曲松、四环素、多西环素、氧氟沙星、洛美沙星、环丙沙星、阿奇霉素和壮观霉素对淋球菌的最低抑菌浓度(MIC),用纸片酸度法测定β-内酰胺酶,并根据检测结果进行聚类分析。结果所有菌株均对头孢曲松和壮观霉素敏感;其中87.5%对青霉素耐药,88.7%对四环素耐药,产青霉素酶的淋球菌(PPNG)和高水平耐四环素的淋球菌(TRNG)分别占45%和18.8%;对阿奇霉素的耐药率为94.7%;对氧氟沙星、洛美沙星和环丙沙星的耐药率分别为97.5%,95.0%和95.0%;依据监测结果将菌株分成四类,将抗生素分成三类。结论所检测的上海地区80株淋球菌临床分离株的耐药性较为严重,应加强淋球菌耐药性的连续性监测。     

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。     

淋球菌对抗生素耐药性的结果分析

目的：了解淋球菌对5种抗生素的耐药情况。方法：对2000－2001年广西南宁地区分离的160株淋球菌，在系统鉴定的基础上，以琼脂稀释法测定了对青霉素、环丙沙星、头孢曲松、大观霉素和四环素的最小抑菌浓度（MIC），并根据世界卫生组织（WHO）标准判定其敏感、中度敏感及耐药性。结果：在检测的160株淋球菌菌株中，产青霉素酶淋球菌（PPNG）阳性率为4．4％，青霉素、环丙沙星、头孢曲松、大观霉素、四环素耐药率分别为78．1％、91．9％、3．1％、0．6％和48．1％。结论：南宁地区淋球菌耐药以环丙沙星为甚，青霉素和四环素次之，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。     

淋球菌耐药监测15年

目的:了解我国1987～2001年淋病流行中的淋球菌对抗生素的敏感性,为修改淋病治疗方案和制订防治策略提供依据.方法:用琼脂稀释法检测淋球菌对WHO规定的5种核心抗生素的敏感性,用纸片酸度法测定淋球菌产青霉素酶(PPNG)菌株.结果:15年来用琼脂稀释法共检测了7583株菌,青霉素耐药株5399株,占71.20%;PPNG株占17.71%(1056/5964).四环素的耐药株占92.61%(1090/1177);由质粒介导的高度耐四环素淋球茵茵株(TRNG)占14.03%(811/5779).对环丙沙星的耐药性迅速增高,占61.12%(3311/5417).对大观霉素和头孢曲松的耐药菌百分率较低,分别为0.41%(26/6342)和0.39%(23/5853).对南京地区1993～1995年和1999～2001年大观霉素和头孢曲松对淋球菌的MIC50作了比较,结果显示MIC50值并无明显变化.结论:我国近15年流行的淋球菌对青霉素、四环素和环丙沙星的耐药性相当高,而对大观霉素和头孢曲松仍较敏感.为了防止淋球菌耐药菌株的进一步传播应强调对淋病病人进行范围治疗.     

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。     

587株淋球菌对青霉素等7种抗生素耐药观察

目的:对2016-2018年我院分离的587株淋球菌对青霉素等7种抗生素的耐药性监测结果进行分析,了解本地区淋球菌的耐药状况。方法:对2016年1月-2018年12月分离的587株淋球菌,采用微量肉汤稀释法测定对青霉素、环丙沙星、四环素、大观霉素、阿奇霉素、头孢克肟和头孢曲松的最低抑菌浓度(MIC),并采用纸片酸度法测定产β-内酰胺酶淋球菌(PPNG)菌株,判断标准按WHO西太区淋球菌耐药性监测统一标准。结果:587株淋球菌中,共检出PPNG 226株,占38.5%(226/587);TRNG 218株,占37.1%(218/587)。三年间PPNG(2=3.51,P>0.05)和TRNG(2=3.26,P>0.05)的流行率均无统计学差异。青霉素、环丙沙星、四环素、阿奇霉素的耐药率分别为73.8%、99.7%、95.6%、17.9%,未发现头孢曲松、头孢克肟和大观霉素耐药株,但头孢曲松和头孢克肟的低敏率分别为6.5%和9.9%。结论:587株淋球菌对青霉素、环丙沙星、四环素耐药状况严重,但对头孢曲松、头孢克肟、大观霉素敏感性较高。对淋球菌进行持续耐药监测,有助于了解流行菌株的耐药情况,为临床经验用药和合理用药提供依据。     

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。     

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。     

Analysis of the antibiotic sensitivity of Neisseria gonorrhoeae in Guangzhou, Peoples Republic of China

BACKGROUND: Sexually transmitted diseases began to re-emerge in China in the mid 1980s. During the last one and a half decades, Neisseria gonorrhoeae infection has become one of the three most common sexually transmitted diseases in China. At present, resistant strains of N. gonorrhoeae are increasing each year. This study was undertaken to better understand the sensitivity of five antibiotics to N. gonorrhoeae isolates in Guangzhou, China. GOAL: To determine the frequency and diversity of antibiotic resistance, particularly to penicillin and tetracycline, on gonococcal strains in Guangzhou. STUDY DESIGN: Strains of N. gonorrhoeae isolates from 203 patients with uncomplicated urethral gonococcal infections from Guangzhou, China were reviewed from September 1997 to August 1998. All strains were characterized with five different antimicrobials for sensitivity, including penicillin, tetracycline, spectinomycin, ciprofloxacin, and ceftriaxone. RESULTS: Penicillin resistance was present in 121 of 203 isolated strains (59.6%). The plasmid-mediated strains and chromosome-mediated strains among the penicillin-resistant strains that were resistance to penicillin were 5.8% and 94.2%, respectively. Plasmid-mediated strains resistant to penicillin and tetracycline were each 3.4%. Most isolated strains were resistant to ciprofloxacin, accounting for 60.6%. All strains were sensitive to spectinomycin and ceftriaxone. CONCLUSION: N. gonorrhoeae isolates exhibited a high rate of resistance to penicillin and ciprofloxacin. Spectinomycin highly effective for penicillin-producing N. gonorrhoeae, tetracycline-resistant N. gonorrhoeae and the highly resistant strains of ciprofloxacin.     

Antimicrobial susceptibility of Neisseria gonorrhoeae strains isolated in Guangzhou, China, 1996-2001

OBJECTIVE: To investigate the in vitro antimicrobial susceptibility and resistant trends of Neisseria gonorrhoeae strains isolated in Guangzhou, from 1996 to 2001. METHODS: The agar dilution method was used to determine the minimum inhibitory concentrations (MICs) to four antimicrobials, penicillin G, ciprofloxacin, ceftriaxone, and spectinomycin. The resistance of all strains to four antibiotics was interpreted according to criteria used in the project of surveillance of gonococcal antibiotic susceptibility in the WHO Western Pacific Region. Penicillinase producing N gonorrhoeae (PPNG) was analysed by the paper acidometric method. RESULTS: 793 consecutive N gonorrhoeae isolates collected in Guangzhou were studied from 1996 to 2001. A total of 55 strains of PPNG were identified and the prevalence rapidly spread from 2% to 21.8%. Of the four antibiotics examined, ceftriaxone and spectinomycin appeared to be the most effective agents although two spectinomycin resistant strains were isolated in 1996. Their MIC(50), MIC(90), and geometric mean MIC (MICmean) were all between the sensitive ranges of the interpretative criteria and remained stable over the years. However, resistance increased continuously to penicillin G and dramatically to ciprofloxacin. In 1996-2001, MIC(50), MIC(90), and MICmean of penicillin G increased from 1 micro g/ml to 2 micro g/ml, 4 micro g/ml to 32 micro g/ml, and 0.68 micro g/ml to 2.35 micro g/ml, respectively; those of ciprofloxacin steeply increased from 0.12 micro g/ml to 4 micro g/ml, 2 micro g/ml to 32 micro g/ml, and 0.14 micro g/ml to 2.62 micro g/ml in 1996-9, respectively, and then declined slightly in 2000-1. The prevalence of resistant isolates spread from 57.2% to 81.8% for penicillin G and from 17.6% to 72.7% for ciprofloxacin over the 6 years. CONCLUSION: Resistance to penicillin and ciprofloxacin increased greatly during 1996-2001. Ceftriaxone and spectinomycin should be used as the first line agents in treating gonorrhoea. It is of great importance to continuously survey the susceptibilities of N gonorrhoeae to antibiotics in controlling the spread of gonococcal infections.     

1988-2002年上海分离的淋球菌对抗菌药的敏感性监测

目的 了解上海地区1988-2002年淋球菌对多种抗菌药耐药的发生率、流行情况和耐药特征.方法 采用琼脂稀释法测定抗菌药耐药性,纸片酸度定量法测定青霉素产β-内酰胺酶菌株(PPNG).结果 青霉素敏感性从1988年的11.28%降至2002年的0,MIC50和MIC90分别增加了8倍和4倍,2002年的耐药率达到94.29%,PPNG株达到了50.95%;高度耐四环素株(TRNG)从1995年的0上升到2002年的20.95%;头孢曲松敏感株已由1995年的100%下降至2002年的23.80%;大观霉素的敏感性维持在高点(>97%);环丙沙星敏感性有较大幅度下降,其耐药率在2002年达到了99.05%.分析多重耐药株,同为耐青霉素、环丙沙星和四环素3种药物的菌株从2001年的20.87%上升到2002年的23.30%.同为耐青霉素和环丙沙星2种药物的菌株近2年都已接近70%.结论 近15年来,淋球菌对多种药物产生了耐药,耐药率逐年提高.建议上海地区将大观霉素和头孢曲松作为治疗淋病的首选药物,并且尽早研制出对淋球菌敏感的抗菌药.     

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.     

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。     

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.