2012-2021年成都地区淋病奈瑟菌耐药变迁
Tendency of drug resistance of Neisseria gonorrhoeae in Chengdu from 2012 to 2021
李春花 1王有为 1李红霞 1田咏梅 1雍刚 1喻林冲 1贺元 1罗才会1
作者信息
- 1. 电子科技大学附属医院·四川省人民医院临床医学检验中心,成都 610072
- 折叠
摘要
目的 分析成都地区性病监测点淋病奈瑟菌临床分离株对常用抗菌药物的耐药变迁,为淋病的治疗提供实验室依据.方法 收集2012-2021年成都地区性病监测点临床分离的淋球菌菌株,采用纸片酸度法测定产青霉素酶淋球菌,琼脂稀释法测定四环素、青霉素、环丙沙星、阿奇霉素、头孢曲松和大观霉素的最小抑菌浓度(MIC).结果 10年间共监测1002株淋球菌.产青霉素酶淋球菌(PPNG)564株(56.29％)、高水平耐四环素淋球菌(TRNG)421株(42.02％),PPNG和TRNG阳性率分别在51.04％～68.63％、26.13％～59.09％,PPNG变化趋势较平稳,而TRNG呈明显的下降趋势(x2=69.809,P＜0.01).青霉素耐药率66.67％～94.87％,呈前升后降趋势且变化明显(x2=44.730,P＜0.01),而中介率呈前降后升趋势(从15.45％降至5.13％后逐年升至29.73％).环丙沙星的耐药率维持在较高的水平(93.75％～100％).阿奇霉素平均非敏感率10.33％,MIC50和MIC90均下降了 1个稀释度.10年间头孢曲松非敏感率1.90％,MIC90上升了2个稀释度;大观霉素中介率和耐药率分别为0.90％和0.20％.结论 头孢曲松和大观霉素可以继续作为成都地区治疗淋病的一线药物,未来阿奇霉素或许也可加入该行列.
Abstract
Objective To analyze the tendency of common antibiotic resistance in clinical isolates of Neisseria gonorrhoeae(NG)from sexually transmitted diseases(STD)surveillance sites in Chengdu,and to provide a laboratory basis for guiding clinical treatment of gonorrhea.Methods The clinical isolates of NG were collected from the STD surveillance sites in Chengdu from 2012 to 2021.Penicillinase-producing NG(PPNG)was detected by the paper acidity method and the minimum inhibitory concentration(MIC)of tetracycline,penicillin,ciprofloxacin,azithromycin,ceftriaxone and spectinomycin were determined by the agar dilution method.Results A total of 1002 NG strains were tested in 10 years.The detection rates of PPNG and plasid mediated high-level tetracycline-resistant NG(TRNG)strains were 564(56.29％)and 421(42.02％)respectively.The positive rates of PPNG and TRNG were 51.04％～68.63％and 26.13％～59.09％,respectively.The change trend of the PPNG was relatively stable,while the TRNG showed a significant decreased trend(x2=69.809,P＜0.01).The resistance rate of penicillin ranges significantly from 66.67％to 94.87％,which showed a trend of increasing before and decreasing after(x2=41.482,P＜0.01),while the intermediary rate showed a trend of decreasing before and then increasing(from 15.45％to 5.13％and then increasing year by year to 29.73％).The resistance rate of ciprofloxacin was at a high level from 93.75％to 100％.The average non-sensitive rate of azithromycin was 10.33％.There was a dilution decrease of MIC50and MIC90 for azithromycin.In the past 10 years,the non-sensitive rate of ceftriaxone was 1.90％,and its MIC90 increased by 2 dilutions.The intermediate sensitivity and resistance rates of spectinomycin were 0.90％and 0.20％respectively.Conclusion Ceftriaxone and spectinomycin could continue to be the first-line drugs for the treatment of gonorrhea in Chengdu area and azithromycin might also join the ranks in the future.
关键词
淋病奈瑟菌/抗菌药物/耐药监测/最小抑菌浓度Key words
Neisseria gonorrhoeae/Antibiotics/Drug resistance monitoring/Minimum inhibitory concentration引用本文复制引用
基金项目
国家自然科学基金青年项目(21605132)
出版年
2024
NETL
NSTL
万方数据