淋球菌对大观霉素等5种抗生素的耐药性监测

目的　监测广州地区 2 0 0 2～ 2 0 0 3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　 10 7株淋球菌中检出 96株对青霉素耐药 (89.7% ) ,产 β-内酰胺酶淋球菌 (PPNG) 2 0株(占 18.7% ) ;四环素耐药率为 6 5 .4 % ,其中质粒介导高度耐四环素淋球菌 (TRNG)为 31株 ,占 2 9.0 % ;环丙沙星耐药率为 88.8% ;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 ,尤其是青霉素为甚 ,其 MIC50 及 MIC90 均超过耐药标准的 8倍和 6 4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

Surveillance of resistance of Neisseria gonorrhoeae to spectinomycin and other four antibiotics

Objective To investigate the antibiotic susceptibility and the resistant trend of Neisseria gonorrhoeae isolated in Guangzhou in 2002~2003. Methods The agar dilution method was used to determine the minimum inhibitory concentrations (MICs) to five antibiotics, penicillin G, tetracycline, ciprofloxacin, ceftriaxone and spectinomycin. The resistance of all strains to five 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 analyzed by the paper acidometric method. Result One hundred and seven N.gonorrhoeae isolates collected in Guangzhou were studied in 2002~2003. Penicillin-resistance rate was 89.7% (96/107) and PPNG 18.7% (20/107). 65.4% of tetracycline-resistant isolates were identified and high level tetracycline-resistant (TRNG) accounted for 29.0%. The prevalence of ciprofloxacin-(resistance) was 88.8%, while none of the strains appeared to be resistant to ceftriaxone and spectinomycin, (respectively.) MIC (50) and MIC (90) of penicillin, tetracycline and ciprofloxacin were significantly higher than resistant standards, especially 8 and 64 times higher for penicillin. Conclusion Resistance to penicillin, tetracycline and ciprofloxacin spread seriously in Guangzhou. Ceftriaxone and spectiomycin should be used as the first-line agents in treating gonorrhea.