CAJ | 학술논문

目的探讨海南淋球菌耐药状态及耐药基因分型情况.方法用琼脂稀释法测定4种抗生素的最低抑菌浓度(MIC),PCR方法鉴定四环素高度耐药菌株(TRNG)并进行TetM基因分型;用纸片酸度法测定β内酰胺酶(PPNG),PCR方法鉴定β内酰胺酶质粒并进行TEM-1基因分型.结果 2011-2012年共检测214株淋球菌,环丙沙星中度敏感率7.94 ％(17/214),耐药率为92.06％(197/214);头孢曲松敏感率24.30％(52/214),中度敏感率为75.70％(162/214);未发现耐大观霉素的菌株.多重耐药情况:对四环素和青霉素耐药的菌株39株(18.22％),对青霉素和环丙沙星耐药菌株66株(30.84％),对四环素和环丙沙星耐药的菌株91株(42.52％),对四环素、青霉素和环丙沙星耐药的菌株37株(17.29％).检出TRNG 101株(47.20％),TetM基因分型结果99株(98.02％)荷兰型,2株(1.98％)美国型.检出PPNG 65株(30.37％),TEM-1基因分型结果55株(84.62％)亚州型,10株(15.38％)非州型,未见多伦多型、里约型.结论海南省淋球菌对大观霉素敏感率高,应作为治疗淋病的首选药物;多重耐药菌株应引起重视.PPNG以亚州型为主,非州型次之;TRNG以荷兰型为主,偶见美国型.
목적 탐토해남림구균내약상태급내약기인분형정황.방법 용경지희석법측정4충항생소적최저억균농도(MIC),PCR방법감정사배소고도내약균주(TRNG)병진행TetM기인분형;용지편산도법측정β내선알매(PPNG),PCR방법감정β내선알매질립병진행TEM-1기인분형.결과 2011-2012년공검측214주림구균,배병사성중도민감솔7.94 ％(17/214),내약솔위92.06％(197/214);두포곡송민감솔24.30％(52/214),중도민감솔위75.70％(162/214);미발현내대관매소적균주.다중내약정황:대사배소화청매소내약적균주39주(18.22％),대청매소화배병사성내약균주66주(30.84％),대사배소화배병사성내약적균주91주(42.52％),대사배소、청매소화배병사성내약적균주37주(17.29％).검출TRNG 101주(47.20％),TetM기인분형결과99주(98.02％)하란형,2주(1.98％)미국형.검출PPNG 65주(30.37％),TEM-1기인분형결과55주(84.62％)아주형,10주(15.38％)비주형,미견다륜다형、리약형.결론 해남성림구균대대관매소민감솔고,응작위치료임병적수선약물;다중내약균주응인기중시.PPNG이아주형위주,비주형차지;TRNG이하란형위주,우견미국형.
Objective To evaluate the antibiotic resistance in Neisseria gonorrhoeae (NG) isolates from Hainan province,and to assess their genotypes according to antibiotic resistance-associated genes.Methods Totally,214 NG strains isolated from Hainan province during 2011-2012 were included in this study.An agar dilution method was used to determine the minimum inhibitory concentrations (MICs) of ciprofloxacin,ceftriaxone,spectinomycin and tetracycline in these strains.The production of β-lactamase was tested by a paper acidometric method.PCR was performed to amplify the tetM gene in TRNG strains and TEM-1 gene in penicillinase-producing NG (PPNG) strains for their genotyping.Results Among these NG strains,7.94％ (17/214) were moderately sensitive to ciprofloxacin with a resistance rate of 92.06％ (197/214),24.30％ (52/214) were sensitive to ceftriaxone with a moderate sensitivity rate of 75.70％ (162/214),and none was resistant to spectinomycin.Additionally,39 isolates (18.22％) were concurrently resistant to both tetracycline and penicillin,66 isolates (30.84％) to penicillin and ciprofloxacin,91 isolates (42.52.％) to tetracycline and ciprofloxacin,and 37 isolates (17.29％) to tetracycline,penicillin and ciprofloxacin.Totally,101 TRNG strains were identified from all the isolates,of which,99 (98.02％)harbored the Dutch variant of the tetM gene,and 2 (1.98％) harbored the American variant.There were 65 (31.31％)PPNG strains in these isolates,among which,55 (84.62％) carried the Asian type plasmids,10 (15.38％) carried the Africa type plasmids,and none carried the Toronto or Rio type plasmids.Conclusions The NG isolates from Hainan province is highly sensitive to spectinomycin,which should serve as the first treatment choice for gonorrhea.More attention should be paid to multi-drug resistance in NG.In this region,most PPNG strains carry the Asian type plasmids,followed by the Africa type plasmids,and the Dutch variant of the tetM gene is the most common variant among TRNG strains with the American variant as the occasional form.