淋球菌130株对7种抗生素的耐药性结果分析

目的了解2018年本单位淋球菌对7种抗生素耐药趋势及产青霉素酶淋球菌(PPNG)和质粒介导的高度耐四环素淋球菌(TRNG)流行情况。方法琼脂稀释法测定青霉素、四环素、环丙沙星、大观霉素、阿奇霉素、头孢曲松、头孢克肟的最低抑菌浓度(MIC),根据世界卫生组织(WHO)的标准判定其敏感性;用纸片碘量法检测β-内酰胺酶。结果 130株淋球菌检出PPNG达43.85%(57/130),(TRNG)达22.31%(29/130),环丙沙星耐药率高达96.92%(126/130),阿奇霉素耐药率达16.15%(21/130),大观霉素未发现耐药菌,头孢曲松、头孢克肟敏感率都是90.77%(118/130),中度敏感率达9.23%(12/130)。结论头孢曲松、头孢克肟、大观霉素都未见耐药菌株,仍可推荐为广州地区淋病患者首选药物,但前二者中度敏感率呈动态变化,提示临床应长期监测耐药性动态变化的重要性。

Analysis of Resistance in 130 Strains of Neisseria Gonorrhoeae to Seven Antimicrobial Agents

Objective To analyse antimicrobial resistance of Neisseria gonorrhoeae to seven antimicribial agents and the penicillinase-producing Neisseria gonorrhoeae(PPNG)and tetracycline resistant Neisseria gonorrhoeae(TRNG)in Guangzhou region in 2018.Methods All Neisseria gonorrhoeae strains were isolated and cultured from our clinical department.Minimum inhibitory concentration(MIC)of penicillin,tetracycline,ciprofloxacin,spectinomycin,azithromycin,ceftriaxone,cefixime were determined by agar dilution method;β-lactamase was measured by paper iodine quantitative method.Results PPNG and TRNG accounted for 43.85%(57/130)and 22.31%(29/130)of the Neisseria gonorrhoeae isolates,respectively.The antibiotic resistant rate of ciprofloxacin and azithromycin were 96.92%(126/130)and 16.15%(21/130).All isolates were susceptible to spectinomycin.Both sensitivity rate of ceftriaxone and cefixime accounted for 90.77%(118/130),both moderate sensitivity rate was 9.23%(12/130).Conclusion The resistant strains to spectinomycin,ceftriaxone and cefixime were not found and these antibiotics can still be used as the first-line drugs for the treatment of Neisseria gonorrhoeae in Guangzhou. However,the dynamic changes moderate sensitivity rate of ceftriaxoneand cefixime shows that it is essential to continuously monitor antimicrobial resistanceof Neisseria gonorrhoeae.