南昌地区淋球菌对抗生素耐药性研究

目的 了解南昌地区淋球菌对抗生素的耐药性及产β-内酰胺酶淋球菌(PPNG)和高水平耐四环素淋球菌(TRNG)的流行状况。方法 采用琼脂稀释法测定5种抗菌药物对120株淋球菌的最低抑菌浓度(MIC)；用改良碘定量法检测PPNG菌株。结果 淋球菌对青霉素、四环素、环丙沙星、大观霉素及头孢三嗪的耐药率分别为74．17％，76．67％，38．33％，1．67％，3．33％。检出16株(13．33％)PPNG菌株，15株(12．5％)TRNG菌株；同时对青霉素、四环素、环丙沙星耐药的菌株占31．67％。结论 头孢三嗪、大观霉素仍可作为南昌地区治疗淋病的首选用药．但淋球菌对青霉素、四环素及环丙沙星耐药率较高。     

海南地区2011年四环素高度耐药淋球菌terM基因分型

目的了解海南地区四环素高度耐药淋球菌（TRNG）的分子流行病学情况。方法采用琼脂稀释法检测TRNG菌株,PCR方法对TRNG菌株鉴定并进行term基因分型;纸片酸度法测定产β-内酰胺酶菌株（PPNG）,PCR方法鉴定B-内酰胺酶质粒并行TEM-1基因分型。结果2011年检测101株淋球菌,检出TRNG54株（53．47％）,其中22株（40．74％）对四环素和青霉素耐药;tetM基因分型结果显示52株为荷兰型,有2株为美国型。22株对四环素和青霉素耐药株的TEM-1基因分型21株为亚洲型,1株非洲型且合并美国型;未见多伦多型、里约型。结论海南地区TRNG流行株以荷兰型tetM基因为主（96．30％）,美国型偶见。     

佛山地区淋球菌流行株对抗生素敏感性测定

目的了解佛山地区2007年分离的淋球菌流行株对青霉素、四环素、大观霉素、头孢曲松和环丙沙星的耐药性及产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最小抑菌浓度(MIC),纸片酸度法检测β-内酰胺酶。结果98株淋球菌检出PPNG34株(34.7%),TRNG63株(64.3%)。青霉素、环丙沙星和四环素的耐药率分别为96.9%、96.9%和94.9%,未发现大观霉素及头孢曲松耐药株。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MIC50及MIC90均超过耐药标准的8倍和32倍。结论大观霉素及头孢曲松是治疗淋病的首选药物。     

Prevalence of resistance of N. gonorrhoeae to penicillin and three other antibiotics in a rural area in Kenya.

Of 90 isolates of Neisseria gonorrhoeae in a rural area in Kenya, 44 (48.9%) produced beta-lactamase (penicillinase). Testing for susceptibility of 35 penicillinase producing N. gonorrhoeae (PPNG) strains to four antibiotics yielded the following results: 16 (45.7%) showed a decreased susceptibility to tetracycline; six (17.1%) showed resistance, probably plasmid mediated; 10 (28.6%) had intermediate susceptibility to gentamicin; one (2.9%) was resistant; and two (5.7%) isolates were resistant to cefotaxime. 16 (57.1%) of 28 non PPNG strains showed a decreased susceptibility to penicillin; 10 (35.7%) were resistant. Nine (32.1%) of 28 non-PPNG isolates showed intermediate susceptibility to tetracycline; one (3.6%) was resistant. Eight of non PPNG isolates (28.6%) showed decreased susceptibility to gentamicin. These results imply that penicillin and tetracycline should be abandoned as primary therapy. For the time being, thiamphenicol and spectinomycin seem to be good alternatives. The observation of cefotaxime resistance in N. gonorrhoeae in a rural area implies a warning concerning future possibilities for use of third generation cephalosporins.     

250株质粒介导的耐药淋球菌株的流行趋势分析

目的了解7年来广州地区质粒介导耐药淋球菌株的流行趋势。方法用琼脂稀释法测定最低抑菌浓度(MICs),筛选出质粒介导四环素耐药淋球菌(TRNG),以及用纸片碘量法测定质粒介导的产青霉素酶的淋球菌(PPNG)。结果846株淋球菌检出PPNG131株(15.5%)、TRNG184株(21.8%),7年来,PPNG、TRNG流行率经μ检验,P<0.01,有显著性差异。结论PPNG和TRNG流行率呈逐年上升趋势,持续监测质粒介导耐药淋球菌株的流行趋势是十分必要的。     

产青霉素酶淋病奈瑟菌的DNA检测

目的 了解产青霉素淋病奈瑟菌（PPNG）耐青霉素的分子机制。方法 收集常州地区50株淋病奈瑟菌，应用TEM基因通用引物套式聚合酶链反应（nPCR)和以TEM－1的3末端及与之相邻基因的5末端为靶基因的PPNG型特异引物nPCR两种方法进行配对检测。结果 TEM－1型的大肠埃希菌、肺炎克雷伯菌、沙雷杆菌、不动杆菌经TEM通用引物nPCR扩增均能呈现535bp的目的条带，而经PPNG TEM－1基因型特异引物nPCR扩增无任何条带出现。50株淋病奈瑟菌检测结果：TEM通用引物nPCR与PPNG TEM－1基因型特异引物nPCR扩增结果一致，有32例呈阳性，阳性率均为64％。对31号菌株PPNG TEM－1基因型特异引物nPCR产物进行全自动DNA测序，测得的序列与NCBI已登录的3种质粒序列（gi 150362、gi 1777422、gi1777428)高度同源。结论 常州地区64％的淋病奈瑟菌为PPNG。由于PPNG TEM－1基因型特异的nPCR只能扩增含TEM基因的PPNG，因此本检测有望用于淋病患者病灶部标本的PPNG DNA流行病学研究和用药参考。     

2002年广州地区淋球菌对4种抗生素耐药性结果分析

目的 了解广州地区2002年淋球菌对抗生素的耐药性及产青霉素酶淋球菌(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四环素、壮观霉素、头孢三嗪和环丙沙星4种抗生素对100株淋球菌的最低抑菌浓度(MIC)及用纸片碘量法检测β-内酰胺酶。结果 100株淋球菌检出PPNG15株(15％)、TRNG28株(28％)，环丙沙星耐药率高达98％，高度耐药株(MIC≥16mg／L)32株(32％)，未发现对头孢三嗪、壮观霉素的耐药菌株，但头孢三嗪的敏感性有所下降。结论目前广州地区流行的淋球菌菌珠耐药状况仍然严重，尤以环丙沙星为甚,但对壮观霉素和头孢三嗪仍较敏感。此外，有必要持续监测球菌的耐药性。     

深圳地区淋球菌营养分型和抗生素耐药性的研究

目的:为了解深圳地区淋球菌的营养型分布和4种抗生素的耐药性。方法:对深圳地区113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:113株淋球菌中检出PPNG菌株9株,TRNG菌株16株,青霉素耐药菌株73株(64.60%),环丙沙星耐药菌株88株(77.88%),大观霉素、头孢曲松未发现耐药菌株。113株淋球菌分16种营养型,以Pro-型、Proto-型、Pro-lle型、Lle-型、Pro-lleSer型5种营养型为主,占86.73%,其余11种营养型占13.27%。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Lle-型,PPNG菌株散在于各种营养型中。结论:深圳地区淋球菌的营养型和耐药性的分布状况,有助于本地区淋球菌的流行病学研究和淋病防治。     

National surveillance of antimicrobial resistance in Neisseria gonorrhoeae. The Gonococcal Isolate Surveillance Project

The Gonococcal Isolate Surveillance Project is a national sentinel surveillance system to estimate levels and monitor trends of antimicrobial resistance in prospectively collected isolates of Neisseria gonorrhoeae. Of 6204 isolates evaluated from 21 clinic sites between September 1987 and December 1988, 21% met at least one of the surveillance criteria for resistance to penicillin, tetracycline, cefoxitin, or spectinomycin; 2.2% were penicillinase-producing N gonorrhoeae; 1.0% had high-level plasmid-mediated tetracycline resistance; and 16.8% of the isolates without plasmid-mediated resistance had chromosomally mediated resistance (defined as a minimum inhibitory concentration greater than or equal to 2 micrograms/mL) to penicillin, tetracycline, or cefoxitin. Three isolates were resistant to spectinomycin. All isolates were susceptible to ceftriaxone. Resistant isolates were identified from all participating centers. Patient demographic and behavioral characteristics were not predictive of infections caused by resistant organisms. These results demonstrate the wide distribution of antimicrobial-resistant N gonorrhoeae and support recent changes in Centers for Disease Control therapy recommendations for gonococcal infections that no longer recommend tetracycline and penicillin as first-line therapies.     

南宁地区221株淋球菌对青霉素、壮观霉素的敏感性测定

目的：了解南宁地区淋球菌对青霉素、壮观霉素的敏感性。方法：我们于1996年至1999年对221株淋球菌临床分离株以琼脂地测定青霉素、壮观霉素的最小抑菌浓度（MIC）。结果：7株（3．17％）为产青霉素淋球菌（PPNG）。青霉素MIC范围为0．008－16mg/L;2.71%菌株对青霉素敏感,36．20％为低敏,61．09％为耐药。其中1996年至1999年各年耐药率分别为23．92％、37．10％、89．16％、90．00％。壮观霉素MIC范围2－＞128mg/L;92．76％菌株对壮观霉素敏感,7．24％菌株为耐药;1999年未发现耐壮观霉素菌株。结论：南宁地区淋球菌对青霉素耐药比率较高,且呈逐年上升趋势。出现了耐壮观霉素的菌株。持续性监测青霉素、壮观霉素对临床合理用药十分重要。     

Epidemic strain Shigella dysenteriae Type 1 Dt66 encodes several drug resistances by chromosome

BACKGROUND: Multiple antibiotic-resistant strains of Shigella dysenteriae type 1 were isolated from an epidemic in West Bengal, India (1984). During the past two decades, much attention was given to reevaluation of treatment recommendations. However, there are no useful data on drug resistance encoded by chromosome. METHODS: A total of 300 strains of Shigella dysenteriae type 1 were isolated from an epidemic. Strains were biochemically identified by API 20E system and further confirmed serologically. Antibiotic susceptibility was determined by disk diffusion method and plasmid DNA was prepared by alkaline lysis procedure. Elimination of plasmids was achieved by curing with acridine orange from a representative epidemic strain S. dysenteriae 1 Dt66. PFGE was performed for typing of wild-type and plasmid-cured strains. Southern blot of PFGE separated XbaI digested chromosomal DNA was done onto positively charged nylon membrane. For Southern hybridization, plasmid DNA was used as probe. RESULTS: All isolates showed identical drug resistance patterns and plasmid profiles. All these isolates contained six plasmids ranging in sizes from 3 to 145 kb. We have eliminated all the plasmids from a representative strain of S. dysenteriae 1 Dt66 by using acridine orange as curing agent. All epidemic Shigella isolates were resistant to amoxycillin, ampicillin, bacitracin, carbenicillin, cefixime, ceftazidime, chloramphenicol, clarithromycin, erythromycin, fusidic acid, methicillin, penicillin G, polymixin B, streptomycin, rifampicin, tetracycline and vancomycin, among 29 antibiotics used. Out of 17 resistant antibiotics, 12 were encoded by chromosome. Resistance to ampicillin, chloramphenicol, streptomycin, tetracycline and ceftazidime was plasmid encoded. Southern blot hybridization showed the recognition of two clear sites in the chromosome used plasmid DNA of Dt66 strain as probe, which reveled some sequential genetic homology between chromosome and plasmids. Pulsed-field gel electrophoresis (PFGE) was performed for typing of the chromosome of plasmidless strains of Dt66 and wild-type strain Dt66 (having plasmids) that remain unaltered. CONCLUSIONS: Seventy percent drug-resistant loci of Shigella dysenteriae 1 Dt66 are present in chromosome and the remaining are plasmid mediated.     

男性淋病患者奈瑟球菌57株药敏分析

目的：了解男性淋病患者奈瑟球菌对抗生素的药敏情况。方法：纸片扩散法检测57株淋病奈瑟球菌对7种抗生素的药敏。用头孢硝噻吩纸片法检测产青霉素酶淋病奈瑟菌（PPNG）,以对四环素药敏纸片抑菌圈直径≤19 mm推测为高水平耐四环素淋病奈瑟球菌（TRNG）。结果：淋病奈瑟球菌对青霉素、四环素、环丙沙星敏感性分别为12.3%、17.5%、28.1%;对头孢噻肟、头孢他啶、头孢曲松耐药性分别为5.3%、3.5%、5.3%;无大观霉素耐药株。57株中检出14株PPNG菌株（24.6%）,16株（28.1%）疑为TRNG。结论：淋病奈瑟球菌对青霉素、四环素、环丙沙星耐药性严重,这些药物已不再适合用于淋病治疗;第三代头孢菌素和大观霉素仍是一线用药,但应重视中介株,否则导致严重耐药性。     

Gonorrhoea among Sex Workers in China: Prevalence, Risk Factors, and Resistance to Antibiotics

Since prostitution is illegal in China,few if any specific services exist for sexworkers unless they are arrested and detained in re- education centers.Staff of amaternal and neonatal hospital in Guangzhou felt a community need for a STD careand preventio…     

Susceptibility of Neisseria gonorrhoeae to seven antibiotics in vitro

One hundred consecutive isolates of N. gonorrhoeae were tested for susceptibility to penicillin, ampicillin, tetracycline, erythromycin, kanamycin, cephaloridine and cephalexin by an agar dilution method. Relative resistance to penicillin was frequent. For 39% of isolates the minimum inhibitory concentration (MIC) of penicillin was 0.05 U./ml. or less; in 55% the MIC was 0.5 to 2.0 U./ml. Ampicillin was slightly more active than penicillin G: all isolates were inhibited by 0.5μg./ml. or less. Resistance to tetracycline and erythromycin was frequent with MIC of 1 μg./ml. or greater observed in 32 and 24% of isolates respectively. The MIC of kanamycin for all gonococci was 8 μg./ml. or greater. Cephalexin was slightly more active than cephaloridine, though each drug exhibited a wide range of MIC values. Gonococcus isolates resistant to penicillin (MIC of 1.0 U./ml. or greater) tended to be resistant to the other antibiotics tested.     

大观霉素与其他4种抗生素体外抗淋球菌活性比较

目的：比较大观霉素与其他4种抗生素对临床分离淋球菌的体外抗菌活性。方法采用琼脂稀释法测定淋球菌株抗生素的最小抑茵浓度（ MIC）,按WH0西太区淋球菌耐药性监测统一标准判断敏感性。用纸片酸度定量法检测产B一内酰胺酶淋球菌菌株。结果本研究共测定493株淋球菌,大观霉素对淋球菌的敏感性为100%,其MIC50和MIC90均为16μg/ml,对产B一内酰胺酶淋球菌,大观霉素的MIC50和MIC90也为16μg/ml,均比耐药标准低8倍;其次为头孢曲松,虽未检出耐药株但中敏检出l64株（33.3%）;抗淋球菌活性最差的是青霉素,耐药率为89.0%;环丙沙星和四环素的耐药率也较高,分别为88.2%和85.6%。青霉素、四环素和环丙沙星的MIC。及MIC。均已超过耐药标准,尤其是青霉素最严重,其MIC50和MIC90均超过耐药标准的4倍和l28倍。结论大观霉素对淋球菌具有强大的抗菌活性,头孢曲松对淋球菌的抗菌活性也较高,两者可作为治疗淋病的首选药物,大观霉素对青霉素、四环素和环丙沙星耐药率较高,提示这3种抗生素对淋病的治疗作用差。     

长沙地区淋球菌流行株的药物敏感性检测

目的 :了解长沙地区淋球菌流行株对抗菌药物的敏感性 ,为淋病的防治提供实验依据。方法 :改良碘量法检测 β 内酰胺酶 ,纸片扩散法检测 86株淋球菌对 9种抗菌药物的敏感性。结果 :质粒介导的产青霉素酶淋球菌(PPNG)和质粒介导的高度耐四环素淋球菌 (TRNG)分别为 35株 (40 .6 9% )和 2 0株 (2 3.2 6 % )。在测定的 9种抗菌药物中 ,淋球菌耐药性较高的依次为四环素、头孢美唑、青霉素、环丙沙星、氧氟沙星 ,耐药率分别为 4 5 .35 % ,5 0 .0 0 % ,6 2 .79% ,77.91% ,87.2 1%。而敏感性较高的 4种抗菌药物依次为头孢呋辛、头孢三嗪、头孢吡肟、壮观霉素 ,敏感率分别为 77.91% ,80 .2 3% ,86 .0 5 % ,98.84 %。结论 :青霉素、四环素以及氟喹诺酮类药物已不宜作为长沙地区治疗淋病的常规药物 ;壮观霉素可作为治疗淋病的首选药物 ,但已出现耐药菌株 ,应当引起高度警惕     

Penicillinase-producing Neisseria gonorrhoeae in Canada.

The incidence of infection with penicillinase-producing Neisseria gonorrhoeae (PPNG) reported to the Laboratory Centre for Disease Control in Ottawa has steadily increased since the first Canadian isolation of such a strain in 1976. As of September 1980 a total of 66 PPNG isolates had been referred for biological and genetic characterization as well as for central documentation of the epidemiologic aspects of each case. Over 90% of the infections were firmly traced to patients or contacts who had acquired the infection abroad; this indicates that Canada does not, as yet, have an epidemic focus of PPNG infection. This report includes a synopsis of the biological characteristics of these isolates and an analysis of the results of primary antibiotic treatment that illustrates the importance of considering spectinomycin as the antibiotic of choice for PPNG infections.     

Penicillinase producing Neisseria gonnorhoeae: the review of the present situation in Ibadan,Nigeria

All the isolates of Neisseria gonorrhoeae from patients that attended special treatment Clinic, University College Hospital, Ibadan, Nigeria between 15th January 1997 and 15th December 1999 were studied so as to review the present prevalence rate of penicillinase producing Neisseria gonorrhoeae (PPNG) in Ibadan. Of the 214 patients that had gonococcal infections, 161 were male (75.2%) and 53 (24.8%) were female. Ninety-two (57.1%) of the male and 28(52.8%) of the female were aged between 20- 29 years while 19.9% of the male and 15.1 % of the female were in the age of 40 and above. The sex difference is not statistically significant (chi2=2.19, df=3, p=0.53). The present study revealed that PPNG strains have increased dramatically to 98.6 per cent. This has posed a great threat to the usefulness of penicillin and ampicillin as the drugs of choice in gonococcal therapy in Nigeria.     

Cross-Canada survey of susceptibility of Neisseria gonorrhoeae isolates to six antimicrobial agents.

The minimum inhibitory concentrations (MIC's) of penicillin, ampicillin, tetracycline, erythromycin, spectinomycin and sulfadiazine were determined for 732 isolates of Neisseria gonorrhoeae collected in 1973-74. Comparison of the results of this survey with data from other Canadian studies showed that the percentage of isolates resistant to tetracycline had not changed since 1966, but that the percentage of erythromycin-resistant isolates had decreased. After an initial increase in 1966 the percentage of penicillin-resistant isolates stabilized. Spectinomycin-resistant isolates were not found. Positive correlations were observed between the MICs of the antibiotics tested; the highest positive correlations were between penicillin and ampicillin and between penicillin and tetracycline. A positive correlation was also noted between penicillin resistance and increasing spectinomycin MICs. Finally, a significant seasonal variation in MICs was found, the trend being towards increasing MICs during the summer.     

长沙地区淋球菌流行株的药物敏感性检测

目的：了解长沙地区淋球菌流行株对抗菌药物的敏感性，为淋病的防治提供实验依据。方法：改良碘量法检测β－内酰胺酶，纸片扩散法检测86株淋球菌对9种抗菌药物的敏感性。结果：质粒介导的产青霉素酶淋球菌（PPNG）和质粒介导的高度耐四环素淋球菌（TRNG）分别为35株（40.69%)和20株（23.26%)。在测定的9种抗菌药物中，淋球菌耐药性较高的依次为四环素、头孢美唑、青霉素、环丙沙星、氧氟沙星，耐药率分别为45.35%，50.00％，62.79%，77.91%，87.21%。而敏感性较高的4种抗菌药物依次为头孢呋辛、头孢三嗪、头孢吡肟、壮观霉素，敏感率分别为77.91%,80.23%,86.05%,98.84%。结论：青霉素、四环素以及氟喹诺在药物已不宜作为长沙地区治疗淋病的常规药物；壮观霉素可作为治疗淋病的首选药物，但已出现耐药菌株，应当引起高度警惕。