广州地区淋球菌对抗生素耐药性测定结果

用琼脂稀释法测定青霉素、头孢三嗪、壮观霉素、环丙沙星、四环素５种抗生素对１２４株淋球菌的最低抑菌浓度（ＭＩＣ），以及用纸片磺量法检测β－内酰胺酶了。结果显示：１２４株淋球菌检出β－内酰胺酶菌株（ＰＰＮＧ）４株（３．２２％）、耐四环素菌株（ＴＲＮＧ）阳性２株（２．６２％）、环丙沙星高度耐药株ＭＩＣ大于８ｍｇ／Ｌ１９株（１５．３％），未发现对头孢三嗪、壮观霉素耐药菌株，但头孢三嗪敏感性呈下降趋势，应引     

淋菌球质粒及其与耐药性关系的研究

检查重庆地区分离的１００株淋球菌粒和抗生素敏感性，质粒检出率９２％，其中１８株带２５．２Ｍｄ质粒。耐青霉素菌株７株，其中ＰＰＮＧ２株，耐四环素菌株４８株，共中ＴＲＮＧ１８株，所有ＴＲＮＧ均带有２５．２Ｍｄ质粒，以上结果显示ＴＲＮＧ在我国内并非少见，并且与２５．２Ｍｄ质粒密切相关。     

湛江地区淋球菌流行株质粒谱型的研究

为探讨淋球菌耐药谱与质粒谱之间的相互关系,对１９９８年－１９９９年广东省湛江地区分离鉴定出的９８株淋球菌,以碱裂解法进行质粒的抽提,并分析质粒谱型的分布情况。结果显示９８株淋球菌流行株,检出质粒的有９０株,占９１．８４％;质粒谱型１２种,以７．４ｋｂ＋４．２ｋｂ,３９．５ｋｂ＋７．４ｋｂ＋４．２ｋｂ为主,占３８．７６％,从而揭示湛江地区淋球菌流行株质粒的分布现状,为该地区淋病的分子流行病学研究打下     

淋球菌对五种抗菌药物的敏感性测定及营养型分布

为了解淋球菌分离株耐药的比率及特性，以评价现行淋病治疗方案的有效性及药物敏感性与营养型之间的关系，我们对１９９４年７月至１９９５年６月由四个城市性病门诊患者分离的３９０株淋球菌作了抗菌药物敏感性及营养型测定。以琼脂稀释法测定了５种监测抗菌药物的最小抑菌浓度（ＭＩＣ）。５株为产青霉素酶淋球菌（ＰＰＮＧ）。染色体介导的耐青霉素及耐四环素的菌株（ＭＩＣ≥１ｍｇ／Ｌ）分别为３１４株（８０．５１％）及３７２株（９５．３８％）。４４株（１１．２８％）对环丙沙星耐药（ＭＩＣ≥１ｍｇ／Ｌ）。３８９株（９９．７４％）对壮观霉素敏感（ＭＩＣ≤３２ｍｇ／Ｌ）。全部分离株对头孢三嗪敏感。４０株（１０．２６％）为多重耐药菌株，同时对青霉素、四环素及环丙沙星耐药。３９０株淋球菌中存在８种营养型，以需脯氨酸及原型菌株占优势。需脯氨酸的菌株对环丙沙星的敏感性低于原型菌株。本研究表明，耐青霉素及四环素的菌株比率较高，出现对环丙沙星耐药的菌株。持续性监测淋球菌对抗菌药物的敏感性十分重要。     

1996-2001年广州地区淋球菌耐药性和质粒介导耐药株流行趋势

目的：研究1996-2001年广州地区淋还需菌耐药性和质粒介导耐药株流行趋势。方法：采用琼脂稀释法测定淋球菌的抗生素耐药物和质粒介导的四环素耐药淋球菌（TRNG），用纸片酸度法测定质粒介导的产青霉素酶淋球菌（PPNG）。结果：6年来，共检测了793株临床分离的淋球菌菌株，发现青霉素的耐药率由1996年的57.2％上升到2001年的81.8％，PPNG的流行率由由2％升至21.8％；四环素耐药率较高且稳定，但TRNG流行率由1996年1.5％增至2001年的27.2％。结论：广州地区质粒介导的青霉素和四环素耐药株流行率呈现逐年上升趋势，已成为这些抗生素耐药株的高流行区。     

头孢布烯对淋球菌的药敏试验与治疗无合并症淋病的疗效

目的 了解头孢布对淋病奈瑟球菌的抗菌活性和治疗淋病的疗效。方法 使用孢布稀治疗了６３例无合并症淋病,并采用药敏纸片法检测上述病例的６３株淋球菌菌株对头孢布烯的药物敏感性。结果 ６３株临床淋球菌中高度敏感４８株（７６．２％）,中度敏感７株（１１．１％）,低度敏感８株（１２．７％）,临床疗效：治愈５６例（８８．９％）,有效４例（６．３％）,无效３例（４．８％）。结论 头孢布烯对淋球菌有较高的敏感性,可     

淋球菌对5种抗生素的敏感性测定

对２０６株淋球菌进行青霉素、四环素、头孢三嗪、壮观霉素、环丙沙星的最小抑菌和浓度和β－内酰胺酶测定。结果显示９株为产青霉素酶淋球菌。染色体介导的耐青霉素和耐四环素的菌株分别为９７株（４７．０９％）和１０２株（４９．５１％）。全部分离菌株对头孢三嗪和壮观霉素敏感。３４株（１６．５％）对环丙沙星耐药。该研究为临床医生合理使用抗生素治疗淋病提供实验依据。     

淋球菌对环丙氟哌酸的药物敏感度测定

为了解我国淋球菌对氟喹诺酮类药物的敏感性，以琼脂稀释法测定了１９９４年７月～１９９６年７月由４个城市分离的５３５株淋球菌对环丙氟哌酸的敏感性，环丙氟哌酸最小抑菌浓度的范围为０．００２～〉２ｍｇ／Ｌ，７３株（１３．６４％）对环丙氟哌酸耐药，４９株（９．１６％），对环丙氟哌酸敏感。４１３株（７７．１９％）为低敏，４个城市对氟喹诺酮耐药的淋球菌的比率介于７．４６％～２５．５５％，耐药菌株比率呈上升趋势，     

毛发红糠疹的治疗:14例患者的回顾性研究

１９７３～１９９７年确诊为毛发红糠疹（ＰＲＰ）的１４例患者（男９例,女５例）,年龄为４～８７岁,病程为２～４０月,（平均５．９±１０．５个月）。９例应用维Ａ酸治 疗,其中 ２例为儿童。起始剂量阿维Ａ ０．５Ｍｇ／ｋｇ／ ｄ,或阿维Ａ酯０．９ｍｇ／ｋｇ／ｄ。７例在治疗１个月后有 效,其中２例完全消退,５例至少７０％消退。平均疗 程为１８．８±１８．０个月。２例在４个月和６个月无效 后改用甲氨蝶呤（ＭＴＸ）。用维Ａ酸者有６例出现不 良反应,包括唇炎,面部红斑,皮肤干燥及血甘油三酯升高,均未中断治疗。５例应用…     

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。     

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。     

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.     

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。     

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。     

Antimicrobial susceptibility, auxotype and plasmid content of Neisseria gonorrhoeae in northern Tanzania: emergence of high level plasmid mediated tetracycline resistance.

OBJECTIVE--To study the antimicrobial susceptibility, plasmid content, auxotype and serogroup of strains of Neisseria gonorrhoeae isolated from an urban population of STD clinic attenders in Northern Tanzania. METHODS--The minimum inhibitory concentrations of nine common antimicrobial agents were measured by the agar dilution method against 130 strains of Neisseria gonorrhoeae isolated in a free government STD clinic in Mwanza town. The auxotype, plasmid content and serogroup of these strains were also determined by conventional techniques. RESULTS--65 strains (50%) were penicillinase producers (PPNG), and 34 (26%) exhibited chromosomally mediated resistance to penicillin. Seven (5%) were sensitive to tetracycline; 78 (60%) showed intermediate levels of resistance, and 45 (35%) had high level plasmid mediated resistance (TRNG), all of which carried a 25.2 MDa plasmid. 79 strains (61%) showed decreased sensitivity to trimethoprim-sulphamethoxazole, and five (4%) were resistant to this agent. All isolates were fully sensitive to spectinomycin, azithromycin, cefotaxime, cefuroxime, norfloxacin and ciprofloxacin. One hundred and one strains (78%) were of type W11/111, 22 type W1, and seven cross reacting strains. The W1 strains were significantly more likely to be carrying plasmid mediated resistance to both penicillin and tetracycline. Six different auxotypes were present, the major type requiring proline. Plasmid profiles showed the presence of both the 3.2 MDa and the 4.4 MDa beta-lactamase encoding plasmids. CONCLUSION--a high proportion of gonococcal isolates remain resistant to penicillin in this region, and most isolates are now also resistant to tetracycline, with the emergence of plasmic mediated tetracycline resistance. Trimethoprim-sulphonamide sensitivity is also decreasing. The population of strains is heterogeneous, and both African and Asian beta-lactamase encoding plasmids are present.     

淋球菌营养型与耐药性及质粒的关系

目的 为了解淋球菌的营养型、耐药性及质粒之间的关系.方法 对重庆市收集的83株淋球菌进行营养型、抗生素敏感性和质粒检测.结果 83株菌共分为8个营养型,以Pro-型(51-8%)和Proto型(18-1%)为主.利用琼脂稀释法检测菌株对青霉素、四环素和壮观霉素的敏感性.青霉素耐药株占15.6%,四环素耐药株占70%,壮观霉素耐药株占1-2%.通过快速碱裂解法对其中的44株菌进行质粒检测,70%菌株含24-5Md质粒,80%含2.6Md质粒,66%同时含24-5Md和2.6Md质粒,16%未查到质粒.并发现Pro^-型菌株中青霉素耐药株高于其它营养型(P<0.05),且含24-5Md质粒菌也显著高于其它营养型(P<0.05).含24-5Md+2.6Md质粒菌株中四环素耐药株更常见(P<0.05).检测到1株产青霉素酶淋球菌(PPNG),经质粒消除试验证实其耐药性由4-4Md质粒介导.结论 本研究不仅表明了重庆地区淋球菌营养型、耐药性及质粒的分布状况,而且揭示了它们之间存在一定关系.这将对该地区淋球菌的流行病学调查和淋病防治提供帮助.     

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.     

Antimicrobial susceptibility of Neisseria gonorrhoeae isolates from three Caribbean countries: Trinidad, Guyana, and St. Vincent

BACKGROUND: The percentage of Neisseria gonorrhoeae isolates resistant to antimicrobial agents commonly used for treatment is unknown in many Caribbean countries. GOAL: To determine the antimicrobial susceptibility of N gonorrhoeae isolates from Trinidad (144 isolates), Guyana (70 isolates), and St. Vincent (68 isolates) so baseline data can be established for further studies, and to assist in establishing effective treatment guidelines. STUDY DESIGN: Consecutive urethral and endocervical specimens from several clinics were collected and identified as N gonorrhoeae. Isolates of N gonorrhoeae were tested for their susceptibility to penicillin, tetracycline, ceftriaxone, ciprofloxacin, spectinomycin, and azithromycin. The presumptive identification of penicillinase-producing N gonorrhoeae and/or tetracycline-resistant N gonorrhoeae isolates based on MIC was confirmed by plasmid and tetM content analysis. RESULTS: High percentages of penicillin and/or tetracycline resistance were observed in N gonorrhoeae isolates from Guyana (92.9%), St. Vincent (44.1%), and Trinidad (42.4%). Isolates from all three countries were susceptible to ceftriaxone, ciprofloxacin, and spectinomycin. One penicillinase-producing N gonorrhoeae/tetracycline-resistant N gonorrhoeae from Guyana had an MIC of 0.5 microg/l to ciprofloxacin. This and nine other isolates from Guyana also were resistant to azithromycin (defined as MIC > or = 2.0 microg/ml) as well as penicillin and tetracycline. A reduced susceptibility to azithromycin was displayed by 16% of the isolates from St. Vincent and 72% of the isolates from Guyana (MIC, 0.25-1.0 microg/ml). Most penicillinase-producing N gonorrhoeae isolates carried Africa-type plasmids (61/90), with 28 of 90 having Toronto-type plasmids and a single isolate carrying an Asia-type plasmid. The tetM determinant in tetracycline-resistant N gonorrhoeae isolates was predominantly of the Dutch type (68/91). CONCLUSIONS: The high prevalence of N gonorrhoeae isolates from 3 of 21 English- and Dutch-speaking Caricom countries in the Caribbean with either plasmid-mediated or chromosomal resistance to penicillin and tetracycline supports international observations that these drugs should not be used to treat gonococcal infections. The detection of isolates with reduced susceptibility to drugs such as azithromycin, which currently are recommended for treatment in the region, attest to the importance of the continued monitoring of gonococcal antimicrobial susceptibility for the maintenance of effective treatment guidelines.     

1999年广州地区所见淋球菌对抗生素耐药性结果分析

目的：了解广州地区所见淋球菌对抗生素的耐药性及产青酶淋球菌（PPNG）和高水平耐四环素淋球菌（TRNG）的流行状况。方法：用琼脂稀释法测定最低抑菌浓度（MIC）以及用纸片碘量法检测β-内酰胺酶。结果167株淋球菌检出PPNG9株（5.4%)、TRNG16株（9.6%)、环丙沙星耐药率达78.4%,高度耐药株（MIC≥16mg/L)37株（22.2%)，头孢三嗪、壮观霉素未发现耐药菌株，且抗菌活性最强，头孢三嗪敏感性呈上升趋势。结论：持续监测淋球菌的耐药性十分重要。