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。     

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.     

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。     

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。     

Detection and prevalence of pneumococci with increased resistance to penicillin.

Susceptibility to penicillin was determined for 6000 strains of pneumococci isolated during 1974--76 from patients in Alberta and the adjacent region of the Northwest Territories. Strains were considered to be relatively resistant if the minimum inhibitory concentration (MIC) of penicillin was 0.16 microgram (0.26 U)/mL or more, which is eight or more times greater than the MIC for fully susceptible strains. Resistance was detected in 143 strains (2.4%) isolated from 122 patients and belonging to four capsular types. The MIC of the most resistant strains was 0.32 microgram (0.53 U/mL. Penicillin-resistant strains were highly resistant to oxacillin, the MIC being at least 30 times greater than that for penicillin-susceptible strains. Pneumococci resistant to penicillin may readily be detected by the narrowness or absence of a zone of inhibition around a 1-microgram oxacillin disc in susceptibility tests on blood agar. The degree of resistance reported here is relative and does not necessarily preclude successful treatment with full therapeutic doses of penicillin G, but penicillin preparations that give low blood concentrations may not be suitable for treating infections caused by these strains.     

A surveillance study on penicillin-resistant streptococcus pneumoniae in China

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Epidemic plasmids in Neisseria gonorrhoeae isolated from high-risk population in Bangladesh

Gonorrhoea still remains as one of the most common venereal diseases, causing a wide range of morbidity among the sexually active people. Characterization of the circulating strains of gonococcus containing epidemic plasmids is important to formulate control strategy. Keeping in mind the above consideration, a total of 495 Neisseria gonorrhoeae isolates with known minimum inhibitory concentration (MIC) values and antimicrobial susceptibility to penicillin and tetracycline were investigated for plasmid content of either PPNG (penicillinase producing N. gonorrhoeae) or TRNG (tetracycline resistant N. gonorrhoeae) or both. Isolates of N. gonorrhoeae showing resistance to penicillin (penicillin MIC ≥ 2 μg/ml, n=255) and high-level tetracycline resistance (tetracycline MIC ≥ 8 μg/ml, n=396) were tested by polymerase chain reaction. The oligonucleotide primers developed to differentiate between three related, epidemic PPNG plasmids (Asia type, Africa type or Toronto/New Zealand type) were used to identify PPNG plasmids and the primers developed to distinguish between American and Dutch variants of Tet-M gene were used to identify TRNG plasmids. A total 169 (34.1%) of the N. gonorrhoeae isolates were found to carry PPNG plasmids and all of them were Africa type showing the amplified products of 3.1 kb. A total 382(77.2%) of the isolates were found positive for TRNG plasmids and almost all were Dutch type (377, 98.7%) with a few American type (5, 1.3%). Although the rate of plasmid infection of either PPNG or TRNG types were very high, because of the presence of only one variant, they are supposed to be endogenously acquired. Therefore, a control strategy, considering the sexual behaviour of the local high risk populations as well as the susceptibility pattern of the circulating N. gonorrhoeae-derived treatment regimen might suffice to control the disease in Bangladesh.     

成都市新都地区2012年-2014年儿童感染肺炎链球菌的分布及耐药性分析

目的：了解儿童感染肺炎链球菌的分布及耐药情况,为临床合理使用抗菌药物提供依据。方法收集新都地区5家监测医院2012年1月—2014年12月自患儿血液、痰、咽拭子、耳分泌物等部位分离出的肺炎链球菌,用奥普托欣纸片和乳胶凝集试验进行鉴定,用法国生物梅里埃公司的 ATB STREP 5肺炎链球菌药敏试剂对细菌进行最低抑菌浓度（MIC）测定,补充药敏试验用琼脂纸片扩散（K-B）法进行检测。结果共分离到肺炎链球菌301株,主要来自痰236株（78.4%）、咽拭子59株（19.6%）、血液3株（1.0%）、耳分泌物3株（1.0%）,301株 SP对红霉素、克林霉素、四环素、复方新诺明的耐药率较高,分别为99.00%,95.68%,90.37%,83.72%,对青霉素、阿莫西林、头孢噻肟、达福普汀/喹奴普汀、氯霉素的耐药率较低,分别为4.98%,5.31%,4.32%,2.66%,14.29%;未发现左氧氟沙星、万古霉素耐药菌株。结论新都地区红霉素、克林霉素、四环素、复方新诺明的耐药率较高,不宜用于儿童 SP 感染的治疗;青霉素和头孢类抗生素敏感率较高,可用于经验治疗。临床应根据药敏试验结果合理用药,防止耐药菌株流行传播。     

北京地区肺炎链球菌的耐药性及其分子流行病学调查

目的 了解北京地区肺炎链球菌的耐药性以及青霉素耐药株的分子流行病学特征。方法 １９９７年９－１１月采集北京市８所幼儿园９８５名儿童鼻咽拭子标本,分离培养肺炎链球菌,用Ｅｔｅｓｔ法和琼脂稀释法测定菌株对１２种抗生素的最低抑菌浓度,用“荚膜肿胀”技术测血清分型,燕用盒式聚合酶链反应分析青霉素耐药株的亲缘关系。     

Antibiotic sensitivities of Neisseria gonorrhoeae in the Toronto area

The antibiotic sensitivity pattern of 3872 isolates of N. gonorrhoeae tested in Toronto from 1969 to 1973 is reviewed. An increase in resistance to both penicillin and tetracycline was noted up to 1971, but no further increase has occurred since then. Ninety-seven percent of 135 patients with “sensitive” strains (inhibited by 0.3 U/ml of penicillin and/or 0.5 μg/ml of tetracycline) were cured by either 8 g of tetracycline or 5,000,000 U of penicillin, whereas only 59% of 58 patients with “resistant” strains (requiring 1.0 U/ml of penicillin and/or 2.0 μg/ml of tetracycline for inhibition) were cured by the same dosage. Spectinomycin appears to be an acceptable alternative therapy. Maximum doses of the chosen drug are recommended in the hope of retarding further spread of more resistant organisms.     

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。     

肺炎链球菌对青霉素耐药率的调查

目的 调查了解北京地区肺炎链球菌对青霉素及其他１２种抗生素的耐药情况,方法 对北京儿童医院及北京医科大学第一医院儿科６个月至３岁的门诊及入院首日患儿进行咽拭子标本采集,并迅速接种于平皿中过夜孵育,分离鉴定肺炎链球菌并选用苯唑西林,氯霉素,四环素,头孢曲松及红霉素纸片作药敏试验,用琼脂扩散法作最小抑菌浓度（ＭＩＣ）试验。结果 ９８９个咽拭子标本中共分离出５１株肺炎链球菌,经用 唑西林纸片初步筛选,青     

Development of Resistance of Gonococci to Penicillin: An Eight-Year Study

During the last eight years, 5700 strains of Neisseria gonorrhoeae have been isolated and tested for sensitivity to penicillin and sulfadiazine in the Public Health Laboratory (Toronto). At the beginning of the study 63% of the strains tested were sensitive to a concentration of 0.01 unit of penicillin per ml. of diluent. Since then the gonococcus has gradually developed resistance to this antibiotic until 27% of the strains isolated are now resistant to a concentration of 0.3 unit/ml., and 8% are resistant to 1.0 unit/ml. To overcome this degree of resistance it is necessary to give a soluble penicillin preparation intramuscularly in very high dosage (2-8 million units). At the present time there is an urgent need for a satisfactory substitute for penicillin in the treatment of gonorrhea. None has yet been found.     

2000～2002年北京、上海及广州三地儿童携带流感嗜血杆菌抗生素敏感性监测

目的了解当前我国儿童携带流感嗜血杆菌对常用抗生素的敏感性情况,以便有效指导临床合理用药和预防.方法采用E-test最小抑菌浓度 (MIC) 方法及KB纸片扩散法对2000～2002年北京、上海、广州3所儿童医院上呼吸道感染儿童携带流感嗜血杆菌进行10种常用抗生素敏感性检测.结果氨苄青霉素对898株流感嗜血杆菌的MIC50和MIC90分别为0.25 μg/ml和4 μg/ml,敏感性88.0%,10.6%菌株对氨苄青霉素耐药,所有氨苄青霉素中度敏感株和耐药株均产β-内酰胺酶,分离株产β-内酰胺酶率为12%;分离株对阿莫西林/克拉维酸、头孢曲松、头孢呋辛敏感性均为100%;头孢克罗对分离株MIC50和MIC90分别为1.5 μg/ml和3 μg/ml,敏感性略低(96.1%),耐药率1.8%.流感嗜血杆菌对阿奇霉素、环丙沙星敏感率分别为100%和99%,对氯霉素、四环素、磺胺甲(口恶)唑/甲氧苄氨嘧啶(SMZ/TMP)耐药率分别为11%、18%、54.4%.北京和上海分离株对四环素敏感性分别为57%和61%,明显低于广州分离株(81%);广州和上海分离株对SMZ/TMP敏感性分别为47%和54%,明显高于北京株(35%);2000～2002年的3年中,分离株对氨苄青霉素敏感性呈逐年下降趋势,对氨苄青霉素总体耐药率由2000年的7.7%增加至2002年的14.5%.本研究中,34.5%分离株对8种抗生素均敏感,多重耐药株占12.8%, 敏感株的分布有地区差异.58.5%的分离株分布在5个常见耐药表型中,其中单一SMZ/TMP耐药最多(29.8%);其次,SMZ/TMP和四环素交叉耐药(12.5%),单纯四环素耐药居第三位(9.4%).氨苄青霉素不敏感株对头孢克罗、四环素、SMZ/TMP和氯霉素耐药率分别为23.5%、63.3%、74.5%和63.3%,明显高于氨苄青霉素敏感株(1.6%、51.4%、11.1% 和4.9%);氨苄青霉素与头孢克罗对菌株MIC值呈正相关,与SMZ/TMP和氯霉素对菌株抑菌能力呈负相关.结论三地儿童携带流感嗜血杆菌的产酶率正在上升,导致菌株对氨苄青霉素耐药性增加,分离株对部分抗生素的耐药性有明显地域差异,菌株对氨苄青霉素耐药性与其对氯霉素、SMZ/TMP、头孢克罗耐药性有明显相关性.     

Prevalence of antimicrobial resistance of Streptococcus pneumoniae in Chinese children: four hospitals surveillance

Objective To investigate the nasal carriage of antibiotic-resistant pneumococci in children of <5 years old in the following four cities, Beijing, Shanghai, Guangzhou and Xi’an.Methods A total of 647 pneumococci strains were isolated and detected. Minimal inhibition concentrations (MICs) of antibiotics were determined by E-test. Disk diffusion test was used for the measurement of antimicrobial susceptibility.Results Prevalence of penicillin non-susceptible Streptococcus pneumoniae in the four cities was 41%, with Guangzhou (60.8%) ranking first, followed by Xi’an (45%), Shanghai (37%) and Beijing (25.9%). The majority of penicillin non-susceptibility isolates (23.9%-53.8%) had a low level of resistance (MIC 0.64-1.5 μg/ml). The most sensitive antimicrobials in terms of percentage of susceptible organisms were amoxicillin-clavulanic acid (99.4%), followed by ceftriaxone (92.1%); cefurxime and cefaclor were slightly more sensitive than penicillin with susceptibility of 74.8% and 77.9%. Erythromycin, tetracycline and TMP-SMZ were highly resistant (83.6%, 82.1% and 76.2% respectively). Among erythromycin resistant isolates, 100% were resistant to azithromycin, 98.6% to clarithromycin, 97.2% to roxithromycin and spiramycin, and 96.6% to clindamycin. 97.2% (141/145) were typical of the macrolides-lincosamides-streptogramons B (MLSB ) resistance phenotype, and 2.8% (4/145) were M phenotype. The group of PRSP was with significantly higher rates of non-susceptibility for ceftriaxone (18.4%), cefurxime (58.6%), cefaclor (53.4%), compared with the group of PEN-S (0.5%, 1.8% and 0.2%, respectively) and the rate of multi-drug resistance in the isolates of PRSP group (92.9%) was significantly higher than that of PEN-S group (59.2%).Conclusion The rates of penicillin and multi-drug resistance among isolates of pneumococci carried nasally in are high children and the high prevalence of multi-drug resistance in the Chinese population may be becoming one of the most serious problems in this century.     

219株呼吸道肺炎链球菌的分离及耐药性分析

目的研究呼吸道肺炎链球茵的分离、鉴定及耐药情况,为临床用药提供指导。方法对2008年3月～2009年3月呼吸道感染住院患者的痰液进行培养、鏊定和分离,将获得的219肺炎链球茵株用琼脂稀释法测定青霉素等13种抗茵药物最低押茵浓度（minimuminhibitoryconcentration,MIC）。结果219株肺炎链球茵中,对青霉素敏感者占43．8％（96／219）,中介耐药者占24．7％（54／219）,高度耐药者占31．6％（69／219）。其中对阿奇霉素的耐药率最高,为91．8％;万古霉素的耐药率最低,为O％。结论我院肺炎链球茵对多种药物的耐药率较高,临床应合理选择用药。     

Clinical and laboratory evaluation of penicillin resistant Streptococcus pneumoniae in relation to the mutations of pbp 1a, pbp2b and pbp2x

A total of 210 isolates of Streptococcus pneumoniae (S. pneumoniae) were selected randomly to examine drug susceptibility which were obtained from out- and in-patients who visited Kurume University Hospital and other affiliated hospitals through May 1998 to September 1999. The prevalence of penicillin resistant S. pneumoniae in this study was 39.5% and was compatible with those of previous reports in Japan. From the clinical aspects, the resistant strains of S. pneumoniae have been shown not to be so highly virulent comparing with sensitive strains that only few severe or mortal cases had been reported. Carbapenems, glycopeptides, and fluoroquinolones were shown to be highly active against penicillin-resistant S. pneumoniae strains as evidenced by the low minimum inhibitory concentrations (MICs) though LVFX showed 4 micrograms/ml or higher MICs against some strains. Regarding to the mechanisms of penicillin resistance, penicillin binding proteins coding gene (pbp1a, pbp2x and pbp2b) mutations that cause modifications in these proteins were also examined for all isolates. The multivariate analysis showed statistically significant correlation between higher MIC of penicillin and cephem and pbp1a mutation while no significant contribution of pbp2x and pbp2b to the resistance was demonstrated. Additionally, no significant correlation between pbp mutation and MIC of carbapenem was observed. Furthermore, there were two highly penicillin resistant S. pneumoniae strains with no pbp mutations. Thus the pbp mutations alone were not responsible for the elevation of MIC all beta-lactams. Nevertheless the pbp mutations were detected in advance of actual MIC elevations by inducement experiment in vitro. It indicated that penicillin resistance might be detected earlier than conventional methods. In previous reports some other responsible genes for penicillin resistance were demonstrated. Therefore, it might be possible to presume exact values of MICs of beta-lactams against resistant strains of S. pneumoniae by detecting still unknown genes other than pbps.     

94例小儿肺炎链球菌耐药性分析

目的研究遂宁地区小儿肺炎链球菌的耐药性,以指导临床合理使用抗生素。方法随机抽取入院患儿2000例进行呼吸道分泌物细菌培养,鉴定及药敏试验,(Minimal effective concentration,MIC)测定。结果培养出94株肺炎链球菌,分离率4.7%,52株对青霉素敏感,42株对青霉素耐药,青霉素耐药率44.68%,肺炎链球菌对红霉素、四环素耐药。对头孢呋辛有一定的耐药性,对三代头孢菌素、左氧氟沙星、万古霉素敏感。结论对儿童感染者应首选三代头孢菌素,严重感染者选用万古霉素。     

Penicillin sensitivities of gonoccocci, in 1977-80 from a peripheral health district, and their clinical correlation

Penicillin sensitivities of gonococci isolated from a peripheral health district were observed during 1977-80 by determining the minimum inhibitory concentrations (MIC) of penicillin. During the same period, outcome of penicillin treatment in patients with gonorrhoea was also observed and recorded. Penicillin resistance, as defined, was found in 19·3% strains in these years, but there were year-to-year variations. None of the strains was a penicillinase producer. Association of higher MICs of penicillin with therapeutic failures was not observed in this study until the MICs were greater than 1·0 mg/l. The findings are discussed together with reviews from other published works.     

临床分离的大肠杆菌敏感株和多重耐药株的主动外排系统

目的：研究临床分离的大肠杆菌多重耐药株和敏感株中抗菌药物的主动外排系统。方法：用抽虑法测定大肠杆菌多重耐药株、敏感株以及标准质控菌对四环素和青霉素的积聚。结果：大肠杆菌敏感株和多重耐药株中四环素以及青霉素的稳定药物质量摩尔浓度呈能量依赖性降低,加入能量抑制剂,细胞内药物质量摩尔浓度上升,但敏感株变化轻微,而标准质控菌ＡＴＣＣ２５９２２细胞内四环素和青霉素的质量摩尔浓度在加入能量抑制剂后显著下降。结论：临床分离的敏感株中亦存在能泵出四环素和青霉素的主动外排系统,但其外排功能显著低于多重耐药株