CAJ | 학술논문

目的监测西安地区淋球菌对抗生素的耐药性及产青霉素酶(PPNG)和质粒介导的耐四环素菌株(TRNG),了解淋球菌耐药趋势.方法 2002-2009年从性病门诊确诊的淋病患者中分离647株淋球菌.采用琼脂稀释法检测菌株是否为TRNG及对抗生素最低抑菌浓度(MIC),采用纸片酸度法测定菌株是否产β-内酰胺酶(PPNG).结果 647株淋球菌中,检出216株(33.4%)TRNG,PPNG为290株(44.8%).TRNG的阳性率保持在28.3%～49.2%,只有2005年阳性率是17.3%.PPNG阳性率由2002年的37.1%上升到2005年的64%,呈递增趋势,但2006-2009年又逐年下降,2009年下降到32.3%.大观霉素的耐药率为0～2.8%.环丙沙星的耐药率除2006年(51%)有所下降以外,其余均在80%以上,2005年达到100%.头孢曲松的耐药率除2003年发现4株耐药外,其余无耐药株出现,但敏感菌株逐渐减少,中敏菌株逐年递增.结论淋球菌对大观霉素敏感性高,应做为治疗淋病的首选药物,头孢曲松治疗淋病应注意给足剂量,环丙沙星不能做为治疗淋病用药.
목적 감측서안지구림구균대항생소적내약성급산청매소매(PPNG)화질립개도적내사배소균주(TRNG),료해림구균내약추세.방법 2002-2009년종성병문진학진적임병환자중분리647주림구균.채용경지희석법검측균주시부위TRNG급대항생소최저억균농도(MIC),채용지편산도법측정균주시부산β-내선알매(PPNG).결과 647주림구균중,검출216주(33.4%)TRNG,PPNG위290주(44.8%).TRNG적양성솔보지재28.3%～49.2%,지유2005년양성솔시17.3%.PPNG양성솔유2002년적37.1%상승도2005년적64%,정체증추세,단2006-2009년우축년하강,2009년하강도32.3%.대관매소적내약솔위0～2.8%.배병사성적내약솔제2006년(51%)유소하강이외,기여균재80%이상,2005년체도100%.두포곡송적내약솔제2003년발현4주내약외,기여무내약주출현,단민감균주축점감소,중민균주축년체증.결론 림구균대대관매소민감성고,응주위치료임병적수선약물,두포곡송치료임병응주의급족제량,배병사성불능주위치료임병용약.
Objective To monitor the antibiotic resistance in Neisseria gonorrhoeae, determine the prevalence of penicillinase-producing Neisseria gonorrhoeae (PPNG) and plasmid-mediated tetracycline-resistant Neisseria gonorrhoeae (TRNG) in Xi'an region, and to analyse the trends in antibiotic resistance in Neisseria gonorrhoeae. Methods In total, 647 strains of Neisseria gonorrhoeae were isolated from patients with gonorrhea in sexually transmitted disease (STD) clinic settings from 2002 to 2009. Agar dilution method was used to detect TRNG and determine the minimal inhibitory concentration (MIC) of antibiotics, and paper acidometric method to detect PPNG. Results Of these 647 strains, 216 (33.4%) were TRNG, 290 (44.8%)were PPNG. The prevalence of TRNG strains remained between 28.3% and 49.2% in 2002-2009, except for 17.3% in 2005; the prevalence of PPNG strains increased from 37.1% in 2002 to 64% in 2005, but declined from 2006 to 2009 (32.3%). The prevalence of resistance to spectinomycin maintained at a low level (0 to 2.8%) over these years, while that to ciprofloxacin remained higher than 80% from 2002 to 2009, and accounted for 100% in 2005, with the exception of 51% in 2006. Ceftriaxone resistance was observed in none of these strains except 4 isolates in 2003, but the susceptibility to ceftriaxone decreased yearly. Conclusions Neisseria gonorrhoeae is highly sensitive to spectinomycin, which should serve as the first treatment choice for gonorrhea.Full dose is necessary for the application of ceftriaxone in the treatment of gonorrhea. Ciprofloxacin should not be used to treat gonorrhea.