淋球菌耐药现状及耐药机制研究进展

淋球菌对青霉素、四环素、氟喹诺酮和阿奇霉素等耐药严重,对头孢菌素敏感性降低的淋球菌株正在增加中,偶有大观霉素耐药的淋球菌株。淋球菌对青霉素和四环素耐药机制包括染色体介导的低度耐药和质粒介导的高度耐药。氟喹诺酮耐药主要是gyrA和parC基因发生突变引起。大环内酯类药物耐药与ermF、ermB、ermC基因及mtrR基因突变有关。淋球菌对头孢曲松敏感性降低主要由于penA、mtr等基因突变相关。淋球菌spe位点单步突变导致对大观霉素高度耐药。多重耐药主要与mtrR编码区内的基因突变或多位点突变相关。

Resistance trend of Neisseria gonorrhoeae and its mechanism

There is serious drug resistance in Neisseria gonorrhoeae to penicillin, minocycline, fluoroquinolones and azithromycin. The sen- sitive clinical isolates of Neissena gonorrhocae to cephalosporin have been decreasingly reported all over the world and few resistant strains to spectinomycin are found. Resistant mechanism of penicillin and tetracycline involves low levels of chromosome-mediated resist- ance and high levels of plasmid-mediated resistance. Fluoroquinolones resistance strains of N. gonorrhoeae are associated with mutations genes of gyrA and parC. The mechanisms of resistance to macrolides involve mutations genes of ermF, ermB, ermC and mtrR. Reduced susceptibility of ceftriaxone may be induced by mutations genes ofpenA and mtr. A single-step mutation in Spe gene leads to the high-lev- el spectinomycin resistance. Mutations within the mtrR coding region or the mutations at muhiple loci are associated with multidrug-resist- ant phenotype.