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。     

165株淋球菌耐药性研究

了解济南地区淋球菌对5种抗菌药物的耐药性及PPNG和TRNG的流行状况，为淋病的有效治疗提供依据。采用琼脂稀释法测定抗菌药物的最低抑菌浓度（MIC）以及用纸片碘量法检测菌株的β-内酰胺酶。结果：165株淋球菌检出PPNG46株（27．9％）、TRNG 33株（20％）；环丙沙星的耐药率达98．2％；头孢曲松、大观霉素没有发现耐药菌株，且抗菌活性最强。济南地区淋球菌耐药状况较为严重，头孢曲松和大观霉素可作为治疗淋病的首选药物。     

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。     

159株淋球菌对7种抗生素的耐药性实验研究

目的通过实验研究了解本地区淋球菌对7种抗生素的耐药情况、产β-内酰胺酶淋球菌(PPNG)和质粒介导高度耐四环素淋球菌(TRNG)流行情况。方法用琼脂稀释法测定环丙沙星、四环素、青霉素、阿奇霉素、大观霉素、头孢曲松和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;用纸片酸度法检测β-内酰胺酶。结果 159株淋球菌检出PPNG为78.9%,TRNG为48.4%,多重耐药菌株占比73.6%;对环丙沙星、四环素、青霉素、阿奇霉素的耐药率分别是100%、89.9%、89.3%、14.5%;对大观霉素、头孢曲松、头孢克肟的敏感率分别为100%、95.6%和92.5%。结论本地区淋病患者不宜使用青霉素、四环素、环丙沙星和阿奇霉素,大观霉素、头孢曲松和头孢克肟均可作为治疗药物。多重耐药菌株比例增高,应长期动态监测耐药性变化。     

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。     

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。     

广州地区淋球菌营养分型和抗生素耐药性的研究

为了解广州地区淋球菌的营养型分布和4种抗生素的耐药性,以广州地区167株淋球菌进行MIC测定和PPNG检测,同时对其中113株淋球菌进行营养分型检测。结果显示,167株菌中检出PPNG菌株9株,TRNG16株,青霉素耐药株109株（65.3%）,环丙沙星耐药株131株（78.4%）,大观霉素、头孢曲松未发现耐药株。113株淋球菌分16种营养型,以Pro^-型、Proto型、Pro^-、Ile^-、Ile^-型、Pro^-Ile^-Ser^-型5种营养型为主,占86.5%,其余11种营养型占13.5%。青霉素和环丙沙星的耐药菌株主要分布于Pro^-型中,TRNG菌株主要分布于Ile^-型,PPNG菌株散在于各种营养型中。研究结果表明广州地区淋球菌的营养型和耐药性的分布状况,有助于该地区淋球菌的流行病学研究和淋病防治。     

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.     

广州地区淋球菌耐药趋势的研究

目的　为控制淋病的漫延 ,更加有效地利用药物资源 ,对淋球菌的药物敏感性进行了为期 4年的连续观察。方法　对每年分离的淋球菌进行 5种常用药物 (青霉素、四环素、环丙沙星、壮观霉素和头孢三嗪 )的药敏检测 ,测定淋球菌对以上药物的敏感度及耐药率。结果　壮观霉素及头孢三嗪的药物敏感度无明显改变 ,4年间未发现耐药菌株 ;环丙沙星的耐药率显著上升 ,由 1998年的 5 6.5 %上升至 2 0 0 1年的 71.4% ,PPNG和TRNG菌株在 4年内分别上升10 .0 %和 16.3 %。结论　PPNG和TRNG菌株的明显上升表明淋球菌的耐药趋势正逐渐增强 ;喹诺酮类药物的高耐药率表明该类药物已不再适宜被推荐用于治疗淋球菌感染的首选药物 ;头孢三嗪和壮观霉素尚没有耐药菌株。     

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.     

2006-2011年海南地区淋球菌耐药性监测分析

目的监测2006-2011年海南地区淋球菌对抗菌药物的耐药趋势。方法收集2006-2011年海南部分地区患者中分离的淋球菌384株,用琼脂稀释法测定4种抗生素的最低抑菌浓度(MIC),用纸片酸度法测定β-内酰胺酶。结果产青霉素酶淋球菌(PPNG)阳性率从2006年16.47%上升到2011年30.69%;高水平耐四环素淋球菌(TRNG)阳性率从24.71%上升到53.47%;环丙沙星耐药率在93.33%～100%之间,2010年为86.36%;头孢曲松耐药率从0上升到2.97%,低敏率从24.71%上升到87.88%;大观霉素未发现耐药菌株。结论 PPNG,TRNG,环丙沙星的耐药率明显上升,头孢曲松出现耐药株,低敏株也不断增加,表明了淋球菌的耐药趋势逐渐增强,应引起临床医师的高度警惕;持续监测淋球菌的耐药性十分重要。     

Antimicrobial susceptibility and plasmid profile of Neisseria gonorrhoeae in India (New Delhi)

OBJECTIVES: To determine the antibiotic susceptibility and plasmid profile of all Neisseria gonorrhoeae strains (PPNG and non-PPNG) isolated from May 1995 to March 1996 in Lok Nayak Hospital, New Delhi, India. METHODS: The agar plate dilution method was used to determine the minimum inhibitory concentration of five antimicrobials including norfloxacin and ceftriaxone which are most commonly used for treatment of gonorrhoea in Delhi. Isolates were screened for production of penicillinase by paper acidometric method and plasmid analysis of PPNG and non-PPNG was carried out by agarose gel electrophoresis. RESULTS: 50 consecutive isolates of N gonorrhoeae were studied, 8% among them were found to be PPNG while 28% were highly resistant to tetracycline (TRNG). Reduced susceptibility to norfloxacin (MIC > or = 1 microgram/ml) was observed in 12% of all isolates. All PPNG harboured the 4.4 MDa beta lactamase plasmid along with the 25.2 MDa tetracycline resistance plasmid. Norfloxacin resistance (MIC > or = 1 microgram/ml) was present in 28.5% of TRNG but only in 5.5% of the other gonococcal isolates. CONCLUSIONS: Results of this study clearly demonstrate that antibiotic resistant gonococcal strains of different clones are frequently found in New Delhi. Continued surveillance of susceptibility to currently prescribed antimicrobials and epidemiological studies are essential to prevent treatment failures leading to further spread of resistant strains.


     

广东省5市525株淋球菌临床分离株耐药性的流行病学研究

目的:对2011²012年广东省广州、佛山、江门、肇庆和珠海等五市临床分离的525株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种抗生素的敏感性监测结果进行分析,了解我省不同地区淋球菌耐药株的流行现状。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),敏感性判断按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)标准判断。用纸片酸度法检测产β-内酰胺酶淋球菌(PPNG)菌株。结果:来自五地525株淋球菌中检出430株对青霉素耐药(81.9%),四环素和环丙沙星耐药株(率)分别为484株(92.2%)和514株(97.9%),未发现对大观霉素、头孢克肟和头孢曲松耐药菌株,但头孢曲松中敏有178株(33.9%),头孢克肟中敏只有7株(1.3%)。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189株(36.0%),四环素高度耐药淋球菌(TRNG)248株(47.2%)。2分析显示,肇庆市淋球菌流行株对青霉素的耐药率高于总体水平(2=13.88,P<0.01);广州市四环素耐药率最高(2=10.58,P<0.01);五地市淋球菌对环丙沙星的耐药率较一致(94.1%2012年广东省广州、佛山、江门、肇庆和珠海等五市临床分离的525株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种抗生素的敏感性监测结果进行分析,了解我省不同地区淋球菌耐药株的流行现状。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),敏感性判断按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)标准判断。用纸片酸度法检测产β-内酰胺酶淋球菌(PPNG)菌株。结果:来自五地525株淋球菌中检出430株对青霉素耐药(81.9%),四环素和环丙沙星耐药株(率)分别为484株(92.2%)和514株(97.9%),未发现对大观霉素、头孢克肟和头孢曲松耐药菌株,但头孢曲松中敏有178株(33.9%),头孢克肟中敏只有7株(1.3%)。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189株(36.0%),四环素高度耐药淋球菌(TRNG)248株(47.2%)。2分析显示,肇庆市淋球菌流行株对青霉素的耐药率高于总体水平(2=13.88,P<0.01);广州市四环素耐药率最高(2=10.58,P<0.01);五地市淋球菌对环丙沙星的耐药率较一致(94.1%¹00%);头孢曲松的中敏率之间相差较大(2=19.60,P<0.01),广州收集的淋球菌对头孢曲松的中敏率高于总体中敏率(2=6.96,P<0.01);5地市PPNG流行率有明显差异(2=15.67,P<0.01),其中肇庆PPNG流行率高于总体水平(2=6.31,P<0.05);5地市TRNG流行率无统计学差异(2=4.16,P>0.05)。结论:不同地区的淋球菌流行株对抗菌药物的耐药性有明显差别,广州市收集的淋球菌流行株对头孢曲松中敏率较高,肇庆市收集的淋球菌流行株中PPNG流行率较高。     

福州地区质粒介导淋球菌耐药性监测

目的：明确福州地区由质粒介导产生青霉素酶淋球菌(PPNG)菌株和由质粒介导产生高度耐四环素的淋球菌(TRNG)菌株的流行状况，以制定有效的淋病防治方案。方法：采用纸片酸度法和ⅧC测定法连续检测1999年～2002年间淋球菌分离株的质粒介导耐药情况。结果：4年来，共检测了698株临床分离的淋球菌菌株，PPNG流行率由1999年2．2％上升为2002年8．72％，TRNG由0．6％上升为20．69％。结论：福州地区PPNG、TRNG检查率呈逐年上升趋势，持续监测淋球菌PPNG菌株、TRNG菌株的流行情况，对淋病的防治有重要意义。     

Rapid decline in penicillinase-producing Neisseria gonorrhoeae in Hong Kong associated with emerging 4-fluoroquinolone resistance.

OBJECTIVE--To study the changes in penicillinase-producing (PPNG) and high-level tetracycline resistant (TRNG) Neisseria gonorrhoeae isolated in Hong Kong associated with emerging quinolone resistance (QRNG) over a two year period from November 1992 to October 1994. MATERIALS AND METHODS--Four thousand and eighty-six strains of Neisseria gonorrhoeae isolated, of which 432 were PPNG, were examined for susceptibilities to penicillin and tetracycline by an agar dilution method using the breakpoint minimum inhibitory concentrations (MICs) of 1 and 10 mg/1 respectively. Ofloxacin susceptibility was done using 0.1 and 1 mg/l. Penicillinase production was detected by performing the chromogenic cephalosporin nitrocefin test on all penicillin resistant (MIC > 1 mg/l) strains. RESULTS--Three thousand and eighty (75.4%) and 79 (1.9%) strains were found to be penicillin resistant and TRNG (MIC > 10 mg/l) respectively. Sixty-nine strains (1.7%) were resistant to both, of which 54 (1.3%) were PPNG. Three strains were multiply-resistant to penicillin, tetracycline and ofloxacin; however, none was PPNG. While the percentage of penicillin resistant strains remained stable (mean 75.5%, SD 7.0), TRNG decreased from 4.5% to 2.1%. The most dramatic change was the sharp decline of PPNG from 25.5% in January 1993 to 4.3% in October 1994, concurrent with a linear increase in strains with ofloxacin MIC > 0.1 mg/l. Significant clinical failure was seen in strains having ofloxacin MIC > 1 mg/l (QRNG), which increased drastically from 0.5% to 10.4% during the study period. Selection against PPNG and TRNG strains appeared to occur only when fully quinolone-susceptible strains first become less susceptible (MIC > 0.1 mg/l), but not when these less susceptible strains become fully resistant (MIC > 1 mg/l). CONCLUSION--PPNG is now no longer hyperendemic in Hong Kong. Emergence of QRNG is associated with rapid decline of both PPNG and TRNG. This is the first report of plasmid-curing effect of the 4-fluoroquinolones occurring on an ecological scale.     

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.