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目的:对2011~2012年广东省广州、佛山、江门、肇庆和珠海等五市临床分离的525株淋球菌流行株对青霉素、四环素、环丙沙星、头孢克肟、头孢曲松和大观霉素等6种抗生素的敏感性监测结果进行分析,了解我省不同地区淋球菌耐药株的流行现状。方法:采用琼脂稀释法测定菌株对6种抗菌药物的最小抑菌浓度(MIC),敏感性判断按WHO西太区淋球菌耐药性监测统一标准,其中头孢克肟敏感性试验和判断标准按美国临床和实验室标准化研究所(CLSI)标准判断。用纸片酸度法检测产β-内酰胺酶淋球菌(PPNG)菌株。结果:来自五地525株淋球菌中检出430株对青霉素耐药(81.9%),四环素和环丙沙星耐药株(率)分别为484株(92.2%)和514株(97.9%),未发现对大观霉素、头孢克肟和头孢曲松耐药菌株,但头孢曲松中敏有178株(33.9%),头孢克肟中敏只有7株(1.3%)。青霉素、四环素和环丙沙星的MIC50及MIC90均已超过耐药标准。检出PPNG株189株(36.0%),四环素高度耐药淋球菌(TRNG)248株(47.2%)。2分析显示,肇庆市淋球菌流行株对青霉素的耐药率高于总体水平(2=13.88,P<0.01);广州市四环素耐药率最高(2=10.58,P<0.01);五地市淋球菌对环丙沙星的耐药率较一致(94.1%~100%);头孢曲松的中敏率之间相差较大(2=19.60,P<0.01),广州收集的淋球菌对头孢曲松的中敏率高于总体中敏率(2=6.96,P<0.01);5地市PPNG流行率有明显差异(2=15.67,P<0.01),其中肇庆PPNG流行率高于总体水平(2=6.31,P<0.05);5地市TRNG流行率无统计学差异(2=4.16,P>0.05)。结论:不同地区的淋球菌流行株对抗菌药物的耐药性有明显差别,广州市收集的淋球菌流行株对头孢曲松中敏率较高,肇庆市收集的淋球菌流行株中PPNG流行率较高。
OBJECTIVE: To investigate the prevalence of penicillin, tetracycline, ciprofloxacin, cefixime, ceftriaxone and ceftriaxone in 525 clinically isolated strains of gonococcal strains from 2011 to 2012 in five cities of Guangzhou, Foshan, Jiangmen, Zhaoqing and Zhuhai in Guangdong Province. Hormone and other six kinds of antibiotic susceptibility monitoring results were analyzed to understand the prevalence of gonococcal drug-resistant strains in different parts of our province. Methods: The minimum inhibitory concentration (MIC) of 6 strains of antibacterials was determined by agar dilution method. The sensitivities were determined according to the uniform standard of Neisseria gonorrhoeae drug resistance monitoring in the WHO Western Pacific Region, of which cefixime sensitivity test and criteria American Clinical and Laboratory Standards Institute (CLSI) standard judgment. Production of β-lactamase-producing Neisseria gonorrhoeae (PPNG) strains by paper acidity assay. Results: 430 penicillin resistant strains (81.9%) were detected in 525 Neisseria gonorrhoeae from five places, 484 strains (92.2%) and 514 strains (97.9%) were resistant to tetracycline and ciprofloxacin, respectively No antibiotic resistant strains were observed for spectinomycin, cefixime and ceftriaxone, but there were 178 (33.9%) susceptible to ceftriaxone and 7 (1.3%) sensitive to cefixime. Penicillin, tetracycline and ciprofloxacin MIC50 and MIC90 have exceeded the resistance standard. 189 (36.0%) strains of PPNG and 248 (47.2%) strains of tetracycline highly resistant Neisseria gonorrhoeae (TRNG) were detected. (2) The prevalence of tetracycline resistance was the highest in Guangzhou (2 = 10.58, P <0.01); 2 analysis showed that the resistance rates of penicillin to the gonococcal strains in Zhaoqing were higher than the overall level (2 = 13.88, P <0.01) Five strains of Neisseria gonorrhoeae showed more consistent resistance to ciprofloxacin (94.1% -100%); the difference of the medium sensitivity of ceftriaxone (2 = 19.60, P <0.01) Neisseria gonorrhoeae had a higher sensitivity to ceftriaxone than the overall sensitivity (2 = 6.96, P <0.01). The prevalence of PPNG was significantly different in 5 cities (2 = 15.67, P <0.01) The prevalence rate was higher than the overall level (2 = 6.31, P <0.05). There was no significant difference in the prevalence of TRNG between the five cities (2 = 4.16, P> 0.05). Conclusion: The prevalence of gonococcal strains in different areas is obviously different from that of antibacterials. The prevalence of neisseria gonorrhoeae strains in Guangzhou is higher for ceftriaxone, and the prevalence rate of PPNG in gonococcal strains collected in Zhaoqing City is higher high.