1991年,1996年淋病奈瑟菌耐药谱质粒谱相互关系研究

通过对成都地区１９９１年、１９９６年各５０株淋病奈瑟菌的耐药谱质粒谱进行分析，以便探讨耐药谱与质粒谱之间相互关系。以琼脂扩散法测定每株标本地十二种抗生素的敏感性，碱裂解加溶菌酶法对其进行质粒抽提。结果表明：１９９１年分离的淋病奈瑟菌标本主要以同时耐２种抗生素为主，耐药谱型２４种，质粒谱型５种。１９９６年 标本主要以同时耐３、４种抗生素为主，耐药谱型３４种，质粒谱型增加到１９种，提示：不同时期分离的     

淋病奈瑟菌药物敏感性及质粒谱研究

淋病奈瑟菌(Neisseria gonorrThoea，NG）对多种抗生素的耐药性正逐年上升，耐药谱结合质粒谱分析有助于对其进行耐药性监测和传染源追踪。我们对南昌地区2000—2002年分离出的120株NG进行了药物敏感性研究，并做了产β-内酰胺酶淋病奈瑟菌(PPNC)的检测和耐药质粒及质粒谱(plasmid pmfile)的分析，以期为该地区NG的分子流行病学调查和淋病监测及临床治疗提供依据。     

长沙地区淋病奈瑟菌的耐药性及耐药性质粒分型研究

目的：了解长沙地区淋病奈瑟菌对抗生素的敏感性以及耐青霉素和耐四环素性质粒的流行情况。方法：采用纸片扩散法检测80株淋病奈瑟菌对7种抗生素的敏感性；碱裂解法分析产青霉素酶的淋病奈瑟菌（PPNG）株及耐四环素的淋病奈瑟菌（TRNG）株的质粒图谱；PCR扩增tetM基因片段，并经测序分析其基因型。结果：在测定的7种抗生素中，耐药性最高的为环丙沙星，耐药率为86．25％，敏感性最高的为大观霉素，为100％；PPNG和TRNG的检出率分别为50.0％和27．5％；40株PPNG株质粒电泳后发现除1株为非洲型耐青霉素质粒外，其余均为亚洲型耐青霉素质粒；22株TRNG株的PCR产物电泳条带均在约443bp处，取典型株经DNA测序分析与荷兰型tetM基因具有96％～98％的同源性。结论：质粒介导的淋病奈瑟菌对青霉素和四环素的耐药已普遍存在，本次研究中介导的耐青霉素和耐四环素质粒分别以亚洲型和荷兰型为主。     

淋球菌抗生素耐药谱和质粒图谱研究

目的 为了解广州地区淋球菌的性素耐药谱和质粒谱。方法 采用琼脂稀释法测定了５种抗生素对８９株淋球菌的最小抑菌浓度（ＭＩＣ）和碱裂解法分析１０６株菌的质粒衅谱。结果 ２株为产β－内酰胺酶菌株（ＰＰＮＧ）,３株为质粒介导的高度耐四环素菌株９ＴＲＮＧ０;环丙沙星耐药率较高（６２．９％）,青霉素次之（５９．５％）,头孢三嗪和壮观霉素未发现耐药菌株。质粒检出率为９０．６％,其中２．６Ｍｄ隐蔽质粒携带率为８５．６％,４．５ＭｄＲ质粒为６７．８％,２４．５Ｍｄ结合质粒为３３．８％。质粒谱型以２．６Ｍｄ＋４．５Ｍｄ和２．６Ｍｄ＋４．５＋ｉ２４．５Ｍｄ多见,分别为３７．７％和２５．４％。结论 表明了广州地区淋球菌抗生素耐药谱和质粒图谱,有助于淋病的治疗和防治。     

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     

琼海地区淋病奈瑟菌的耐药性分析

目的了解本地区泌尿生殖道患者感染淋病奈瑟菌的情况,以及对常见抗菌药物的耐药性,为临床合理用药提供科学依据。方法采用常规淋病奈瑟菌培养分离技术;运用生物梅里埃公司VITEK-2 compact全自动细菌鉴定仪上机鉴定;药敏试验方法采用K-B纸片法,操作方法参照美国临床实验室标准化协会(CLSI)规定的标准执行。结果 2010～2016年共培养分离出210株淋病奈瑟菌,对6种抗生素的耐药率依次为环丙沙星93.5%、四环素87.1%、青霉素71.9%、头孢呋辛6.5%、头孢曲松0.0%、大观霉素0.0%。结论在淋病奈瑟菌感染患者中,环丙沙星、四环素、青霉素的耐药率较高,不宜作为一线药物应用。第二、第三代头孢菌素、大观霉素的耐药率较低,可作为本地区治疗淋病的首选药物。     

威海地区淋球菌流行株质粒谱研究

目的:研究威海地区淋病奈瑟菌(简称淋球菌)耐药质粒的传播情况。方法:收集威海地区2000~2003年共82株淋球菌,采用碱裂解法提取质粒,以λDNA/HindIII作为分子质量参照,以标准分子质量的电泳结果为标准系统,以其相对迁移率为自变量,其分子质量对数值为因变量建立回归方程,计算样品所带核酸的分子量。结果:82株淋球菌中检出11株PPNG菌株,阳性率为13.41%。所有PPNG菌株均携带4.5 Kb的“亚洲型”质粒。对由质粒介导的四环素高度耐药株(TRNG)(MIC≥16μg/mL)为2株,加上中度耐药株53株(MIC≥8μg/mL)。82株淋球菌中有74株携带质粒,质粒总检出率为90.2%。共检出4种分子质量的质粒,分别为2.6、4.5、24.5和25.2 Kb,其中2.6 Kb质粒携带为49株,携带率为66.22%,携带4.5 Kb者59株,其中53株(89.83%)对青霉素耐药。携带25.2 Kb质粒的12株对四环素高度耐药。质粒谱共有7种,分别为4.5、2.6、(4.5 2.6)、(24.5 4.5)、(24.5 4.5 2.6)(、25.2 2.6)Kb及非质粒型,其中以(4.5 2.6)Kb和(24.5 4.5 2.6)Kb质粒谱型为主,分别占24.32%和14.86%。结论:质粒介导性耐药(包括PPNG和TRNG)是威海地区淋球菌产生耐药的主要原因。     

淋病奈瑟菌129株耐药性分析

目的监测海口地区淋病奈瑟菌对常用抗生素的耐药状况。方法收集本院性病门诊2004年11月--2007年6月患者泌尿生殖道分泌物中分离的淋病奈瑟菌共129株，用琼脂稀释法测定最低抑菌浓度（MIC），用纸片酸度法测定β-内酰胺酶。结果产青霉素酶淋病奈瑟菌（PPNG）阳性28株（21．71％），高水平耐四环素淋病奈瑟菌（TRNG）阳性45株（34．88％）；环丙沙星耐药127株（98．45％），大观霉素和头孢曲松未发现耐药菌株。结论海口地区的淋病奈瑟菌对环丙沙星的耐药性较高，未发现对大观霉素和头孢曲松耐药的菌株，持续开展常规耐药性监测十分重要。     

南宁地区2000～2007年淋病奈瑟菌耐药性监测分析

目的研究南宁地区2000-2007年淋病奈瑟菌对临床常用几种抗生素的耐药性及产青霉素酶淋病奈瑟菌（PPNG）和高水平耐四环素淋病奈瑟菌（TRNG）的流行情况，为制定防治策略和治疗方案提供参考依据。方法对临床分离的694株淋病奈瑟菌进行系统鉴定后，用琼脂稀释法测定最低抑菌浓度（MIC），用纸片酸度定量法测定β-内酰胺酶。结果在检测的694株淋病奈瑟菌中检出PPNG阳性77株（11．10％），TRNG阳性389株（56．05％），对环丙沙星、头孢曲松和大观霉素的耐药率分别为90．92％，0．86％和0．14％。结论南宁地区淋病奈瑟菌耐药形势严峻，其中对环丙沙星的耐药最为严重，且PPNG菌株和TRNG菌株流行严重，对大观霉素和头孢曲松仍较敏感。     

淋病奈瑟菌体外药敏试验与治疗效果的相关性分析

目的探讨淋病奈瑟菌体外药敏试验与治疗效果的相关性。方法选取2017年6月至2019年6月青岛市胶州中心医院皮肤性病科分离培养出淋病奈瑟菌株的80例患者作为研究对象。随机分为观察组(n=40)和对照组(n=40)。所有分离株均接受青霉素、环丙沙星、四环素、头孢曲松、大观霉素和阿奇霉素的药敏试验。根据药敏试验结果选择抗生素治疗,所有患者均随访评估临床治愈率。结果所有分离株均对环丙沙星耐药,耐药率100%;71株(88.75%)对青霉素耐药,其中15株(21.13%)为产生青霉素酶的淋病奈瑟菌;28株(35.00%)菌株对四环素耐药,其中5株(17.86%)为质粒介导高度耐四环素淋病奈瑟菌。70株(87.50%)、79株(98.75%)和25株(31.25%)分别对头孢曲松、大观霉素和阿奇霉素敏感。观察组起效时间明显短于对照组,总有效率高于对照组,差异具有统计学意义(P<0.05)。治疗后,两组均出现轻微不良反应,观察组不良反应发生率明显低于对照组,差异具有统计学意义(P<0.001)。结论药敏试验提示淋病奈瑟菌对抗生素的耐药性较高。依据药敏试验结果,淋病患者选择合适的抗生素能够有效提高治疗效果,缩短起效时间,降低不良反应发生率,值得临床推广。     

The virgin population of Neisseria gonorrhoeae in Stockholm has decreased and antimicrobial resistance is increasing.

AIMS--To investigate the evolution of chromosomal and plasmid mediated resistance for ampicillin and tetracycline of N gonorrhoeae strains in Stockholm during 1982-1993. METHODS--A total of 404 gonococcal strains isolated in 1982, 1987, 1990, 1992, 1993 were analysed for minimal inhibitory concentrations (MIC) of ampicillin and tetracycline and for plasmid content. MIC values were determined by the agar dilution method and plasmid preparations were performed using alkaline lysis. To detect additional gonococcal strains with tet(M) plasmids all strains isolated in 1988-1989 and 1991, in all 234 isolates, were analysed retrospectively for MIC values of tetracycline. If an MIC value of > or = 4.0 mg/l was recorded plasmid analysis was performed. RESULTS--Increased proportions of chromosomally mediated resistance to tetracycline (p < 0.001) as well as plasmid mediated resistance to both ampicillin (p < 0.02) and tetracycline were found in the later part of the study. In 1991 the first gonococcus with tet(M) plasmid was isolated in Sweden. The proportion of strains with chromosomally mediated resistance for ampicillin did not change during the study period. The proportion of gonococcal strains with the 39 kb conjugative plasmid was increased in the later part of the study. CONCLUSIONS--The increased proportion of N gonorrhoeae strains with resistance to ampicillin and tetracycline is most likely due to importation of strains from areas with high prevalence of antibiotic resistant gonococci. The proportion of N gonorrhoeae strains with tet(M) plasmids is low in Sweden, but might increase in the same way as the proportion of PPNG strains has increased during 1982-1993.     

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.


     

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.     

阳江地区淋球菌质粒谱与耐药性关系研究

目的 研究阳江地区淋球菌流行株质粒谱与耐药性的关系。方法 应用碱裂解和溶菌酶双重处理100株淋球菌流行株，进行质粒抽提及质粒谱分型研究。利用K-B法测定淋球菌流行株对10种抗生素的敏感性。结果 检出4种不同分子量的质粒，其中分子量为4．2kb、7．4kb和39．5kb的质粒检出率较高，分别为66．00％、58．00％和41．00％。质粒谱型共12型，以7．4kb 4．2kb、39．5kb 7．4kb 4．2kb、39．5kb 4．2kb3型为主，分别占21．00％、17．00％和15．00％；耐药谱型42型，以CPLX^R、TCR CPLX^R、CPLX^R CP^R菌株为主，分别占12．00％，、12．00％和7．00％。将3型主要的耐药谱与相应的质粒谱进行比较。结果 CPLX^R菌株以39．5kb 4．2kb质粒谱为主；TC^R CPLX^R菌株以7．4kb 4．2kb质粒谱为主；CPLX^R CP^R菌株以7．4kb和39．5kb 7．4kb 4．2kb质粒谱为主。结论 阳江地区淋球菌流行株的质粒谱与其相应的耐药谱之间有一定的关系。     

不同时期分离的淋病奈瑟菌药物敏感性测定

目的　了解淋病奈瑟菌对抗生素敏感性的变迁情况。方法　对门诊 1991年和 1996年各 10 0株标本进行了 12种抗生素最小抑菌浓度 (MIC)测定。同时对产青霉素酶株 (PPNG)和非产青霉素酶株 (non PPNG)的MIC值进行了比较。结果与结论　青霉素G、四环素等 6种抗生素MIC值 1996年与 1991年两者之间有显著性差异 (P <0 0 5或P <0 0 1)。其中MIC50 值变化较大的是青霉素G和氟哌酸 ,1996年比 1991年均增加 6 3倍。此外 ,PPNG株和non PPNG株MIC值也存在差异     

淋病菌流行株耐药与耐药与耐药质粒谱的研究

目的 了解淋球菌流行株的耐药状况,并对耐药表型及质粒谱进行分型。方法 1998－1999年从广东省湛江地区分离出98株淋球菌流行株, 采用琼脂稀释法测定淋球菌对青霉素、四环素及环丙沙星的敏感性;应用碘量法测定β－内酰胺酶,并对耐药表型进行分型;应用碱裂解法提取相应菌株的质粒,对质粒谱进行分型。结果 淋球菌流行株对青霉素、四环素及环丙沙星的耐药率分别为22．44％、45．94％和55．12％;β－内酰胺酶阳性淋球菌占6．12％（6／98）;耐药表型以Susceptible^PT、CMRNG^T、CMRNG^PT、TRNG四型为主,分别占43．86％、23．46％、10．20％和10．20％;98株淋球菌流行株,质粒总检出率为91．84％,42．5kb、39．5kb、7．4kb、4．2kb质粒分别占11．22、41．82％、59．16％和67．32％;质粒谱型12型,以7．4kb 4.2kb、39.5kb 7.4kb 4.2kb为主,分别占21．42％和17．34％。结论 湛江地区淋球菌流行株对环丙沙星的耐药率较高,耐药表型和质粒谱型各有其分布特点。     

济南地区淋球菌耐药性检测及质粒谱型分析

目的了解济南地区淋球菌对抗生素的耐药性和质粒图谱。方法用琼脂稀释法测定4种抗生素对148株淋球菌的最小抑菌浓度(MIC)及其中70株淋球菌的质粒图谱。结果检出PPNG占28.38%,TRNG占18.92%,环丙沙星耐药达98.99%,头孢曲松、大观霉素未发现耐药菌株。质粒谱型主要有4.2kb+5.4kb(38.58%),4.2kb+7.4kb(20.00%),4.2kb+5.4kb+39.5kb(15.71%)。结论济南地区淋球菌对抗生素耐药性维持在较高水平,头孢曲松、大观霉素是治疗首选;质粒图谱显示出地域特殊性。     

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。     

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.