珠海地区淋球菌耐药性监测及耐药质粒分型

目的 监测珠海地区2015-2016年淋球菌临床分离株对常用抗菌药物的敏感性,了解质粒介导的TEM-1和tetM基因分子流行情况.方法 用琼脂稀释法测定淋球菌对7种抗菌药物(青霉素、四环素、环丙沙星、头孢克肟、大观霉素和阿奇霉素)的最低抑菌浓度(MIC).采用纸片酸度法测定产青霉素酶淋球菌(PPNG),PCR方法分别扩增TIEM-1和tetM耐药质粒基因片段,电泳分析其耐药质粒型别.结果 93株淋球菌中检出PPNG共26株(27.96％)、耐四环素淋球菌(TRNG)24株(25.81％).93株淋球菌对青霉素、四环素、环丙沙星、阿奇霉素的耐药率分别40.86％、75.27％、100.00％、7.53％,青霉素低敏率为51.61％;未发现对大观霉素、头孢曲松、头孢克肟耐药菌株,但对头孢克肟的低敏率达到30.11％.耐药质粒分型结果PPNG亚洲型15株(57.69％),非洲型11株(42.31％),未检出多伦多/里约型;TRNG荷兰型23株(95.83％),美国型1株(4.17％).结论 珠海地区淋球菌对四环素、环丙沙星、青霉素耐药率较高,但对头孢曲松和大观霉素敏感率高,可作为治疗淋病的首选药物;PPNG以亚洲型和非洲型为主,TRNG以荷兰型为主,偶见美国型.

Drug resistance surveillance and plasmid genotyping of Neisseria gonorrhoeae isolated from Zhuhai

Objective To monitor the in vitro antimicrobial susceptibilityof clinical isolates of Neisseria gonorrhoeae from Zhuhai area during 2015-2016,and understand epidemic features of plasmid mediated TEM-1 and tetM genes.Methods The agar dilution method was used to determine the minimum inhibitory concentrations (MICs)of Neisseria gonorrhoeae strains to 7 antibiotics (penicillin G,tetracycline,ciprofloxacin,cefixime,ceftriaxone,spectinomycin and azithromycin).Penicillinase (β-lactamase)-producing N.gone rrhoeae (PPNG) was analyzed by the paper acidometric method.A multi-PCR was used to amplify TEM-1 and tetM gene fragments,and the drug resistant plasmid profiles were analyzed by electrophoresis.Results There were 26 PPNG strains (27.96％) and 24 tetracycline resistant N.gonorrhoeae (TRNG) strains (25.81％) detected out of 93 strains.The resistance rates of 93 strains to penicillin G,tetracycline,ciprofloxacin and azithromycin were 40.86％,75.27％,100.00％ and 7.53％,respectively.The rate of low susceptibility to penicillin G was 51.61％.No ceftriaxone,spectinomycin or cefixime resistant strains were detected.However,the rate of low susceptibility to ceftriaxone was 30.11％.Totally,26 PPNG strains were identified from all the isolates,of which 15 strains (57.69％) carried the Asian type plasmids,11 strains (42.31％) carried the Africa type plasmids,but none carried the Toronto or Rio type plasmids.There were 24 TRNG strains (25.81％) in these isolates,of which 23 strains (95.83％) harbored the Dutch variant of the tetM gene and 1 strain (4.17％) harbored the American variant.Conclusions Clinical isolates of Neisseria gonorrhoeae from Zhuhai have relatively high drug resistance to penicillin G,tetracycline and ciprofloxacin,but have high susceptibility to ceftriaxone and spectinomycin.Therefore,ceftriaxone and spectinomycin can be used as the first-line agents in gonorrhea treatment.In this region,most PPNG strains carry the Asian type plasmids,followed by the Africa type plasmids.The Dutch variant of the tetM gene is the most common variant among TRNG strains,while the American variant is the occasional form.