淋球菌流行株对阿奇霉素等7种抗菌药物敏感性的检测
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摘要
目的:检测2013年度本地区临床分离的淋球菌流行株对青霉素、四环素、大观霉素、头孢曲松、环丙沙星、头孢克肟和阿奇霉素等7种抗菌药物的敏感性,分析耐药菌株的流行特点。方法:采用琼脂稀释法测定85株菌株对7种抗菌药物的最小抑菌浓度(MIC),判断敏感性按WHO西太平洋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:85株淋球菌中检出68株对青霉素耐药(80%),产β-内酰胺酶淋球菌(PPNG)32株(37.6%);四环素耐药率为84.7%,其中质粒介导高度耐四环素淋球菌(TRNG)34株,占40%;环丙沙星和阿奇霉素的耐药率分别为97.6%和3.5%。未发现对头孢曲松、头孢克肟、大观霉素耐药菌株,但头孢曲松和头孢克肟敏感性降低的菌株分别为16.5%和5.9%。青霉素、四环素和环丙沙星的MIC50及MIC90均已超过耐药标准,青霉素和四环素MIC50及MIC90均大于耐药标准的32倍。结论:淋球菌对青霉素、四环素和环丙沙星耐药率较高,对大观霉素、头孢曲松和头孢克肟的敏感性较高,出现阿奇霉素的耐药株。
引文
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[13]Chisholm SA,Neal TJ,Alawategama AB,et al.Emergence of high-level azithromycin resistance in Neisseria gonorrhoeae in England and Wales[J].J Antimicrob Chemother,2009,64(2):353-358.
[14]韩燕,尹跃平,戴秀琼,等.2008年中国淋球菌临床分离株耐药性的流行病学研究[J].中华皮肤科杂志,2011,44(7):472-475.
[15]郭炽星,李小靖,郭廷学,等.淋球菌流行株对5种抗生素敏感性分析[J].国际检验医学杂志,2009,30(6):566-567.
[2]Yuan LF,Yin YP,Dai XQ,et al.Resistance to azithromycin of Neisseria gonorrhoeae isolates from 2 cities in China[J].Sex Transm Dis,2011,38(8):764-768.
[3]叶顺章.性传播疾病的实验室诊断[M].北京:科学出版社,2001:53.
[4]Kirkcaldy RD,Kidd S,Weinstock HS,et al.Trends in antimicrobial resistance in Neisseria gonorrhoeae in the USA:the Gonococcal Isolate Surveillance Project(GISP),January 2006-June 2012[J].Sex Transm Infect,2013,89(Suppl 4):5-10.
[5]Australian Gonococcal Surveillance Programme,Tapsall J.Annual report of the Australian Gonococcal Surveillance Programme,2008[J].Commun Dis Intell Q Rep,2009,33(3):268-274.
[6]Ohnishi M,Golparian D,Shimuta K,et al.Is Neisseria gonorrhoeae initiating a future era of untreatable gonorrhea?:detailed characterization of the first strain with highlevel resistance to ceftriaxone[J].Antimicrob Agents chemother,2011,55:3538-3545.
[7]吴兴中,郑和平,李燕娃,等.淋球菌对头孢克肟等6种抗生素敏感性及耐药质粒分型研究[J].皮肤性病诊疗学杂志,2012,19(6):352-355,358.
[8]Furuya R,Nakayama H,Kanaynma A,et al.In vito synergistic effects of double combinations of beta-lactnms and azithromycin against clinical isolates of Neisseria gonorrhoeae[J].J Infect Chemother,2006,12(4):172-176.
[9]Sathia L,Ellis B,Phillip S,et al.Pharyngeal gonorrhoea—is dual therapy the way forward?[J]Int J STD AIDS,2007,18:647-648.
[10]Palmer HM,Young H,Winter A,et al.Emergence and spread of azithromycin-resistant Neisseria gonorrhoeae in Scotland[J].J Antimicrob Chemither,2008,62(3):490-494.
[11]Starnino S,Stefanelli P,Neisseria gonorrhoeae Italian Study Group.Azithromycin-resistant Neisseria gonorrhoeae strains recently isolated in Italy[J].J Antimicrob Chemither,2009,63(6):1200-1204.
[12]Galarza PG,Alcala B,Salcedo C,et al.Emergence of high level azithromycin-resistant Neisseria gonorrhoeae strains isolated in Argentina[J].Sex Transm Dis,2009,36(12):787-788.
[13]Chisholm SA,Neal TJ,Alawategama AB,et al.Emergence of high-level azithromycin resistance in Neisseria gonorrhoeae in England and Wales[J].J Antimicrob Chemother,2009,64(2):353-358.
[14]韩燕,尹跃平,戴秀琼,等.2008年中国淋球菌临床分离株耐药性的流行病学研究[J].中华皮肤科杂志,2011,44(7):472-475.
[15]郭炽星,李小靖,郭廷学,等.淋球菌流行株对5种抗生素敏感性分析[J].国际检验医学杂志,2009,30(6):566-567.