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目的明确本院淋球菌的耐药情况及产青霉素酶的淋球菌(PPNG)和质粒介导的耐四环素淋球菌(TRNG)流行现状,为临床防治方案的制定提供依据。方法运用VITEK2 Compact全自动微生物鉴定仪对2014年1月至2015年12月本院临床分离菌株进行菌种鉴定,采用琼脂微稀释法测定青霉素、四环素、环丙沙星、头孢曲松和大观霉素5种抗菌药物对淋球菌进行药敏实验,用纸片酸度定量法测定淋球菌株的β-内酰胺酶。结果 183株受试淋球菌中检出PPNG 57株(31.1%),质粒介导的TRNG 59株(32.2%);青霉素、四环素、环丙沙星耐药率分别为91.8%、75.4%和97.3%;未检出头孢曲松耐药菌株,低敏菌株检出率为11.5%;未检出大观霉素耐药及低敏菌株;青霉素、四环素和环丙沙星50%最低抑菌浓度(MIC50)及90%最低抑菌浓度(MIC90)值均已超过耐药标准;淋球菌多重耐药菌株检出率为91.8%(168/183)。结论佛山地区淋球菌临床分离株对青霉素和环丙沙星呈现高耐药率,多重耐药现状严峻。
Objective To clarify the drug resistance of Neisseria gonorrhoeae and the prevalence of Neisseria gonorrhoeae (PPNG) producing penicillinase and plasmid-mediated resistance to tetracycline Neisseria gonorrhoeae (TRNG) in our hospital and provide the basis for the establishment of clinical prevention and treatment plan. Methods The strains of clinical isolates from January 2014 to December 2015 in our hospital were identified by VITEK2 Compact automatic microbial identification instrument. The concentrations of penicillin, tetracycline, ciprofloxacin, ceftriaxone, Five kinds of antibacterials were used to test the susceptibility of Neisseria gonorrhoeae, and the β-lactamase of Neisseria gonorrhoeae was assayed by the paper acidity quantitative method. Results 57 strains (31.1%) of PPNG and 59 strains (32.2%) of plasmid-mediated TRNG were detected in 183 strains of N. gonorrhoeae. The rates of resistance to penicillin, tetracycline and ciprofloxacin were 91.8%, 75.4% and 97.3 %; No drug-resistant strains of ceftriaxone were detected, the detection rate of low-sensitivity strains was 11.5%; no spectinomycin-resistant and low-sensitivity strains were detected; the minimum inhibitory concentration of 50% of penicillin, tetracycline and ciprofloxacin MIC50) and 90% minimum inhibitory concentration (MIC90) were beyond the resistance standard. The detection rate of multiple drug-resistant strains of Neisseria gonorrhoeae was 91.8% (168/183). Conclusion The clinical isolates of Neisseria gonorrhoeae in Foshan showed a high resistance rate to penicillin and ciprofloxacin, and the status of multi-drug resistance was severe.