Tompkins Janine R., Zenilman Jonathan M.
Johns Hopkins University School of Medicine, Ross 1165, 720 Rutland Avenue, Baltimore, MD 21205, USA.
Curr Infect Dis Rep. 2001 Apr;3(2):156-161. doi: 10.1007/s11908-996-0041-5.
Single-dose oral quinolones have been recommended for gonorrhea treatment since 1989. The antimicrobial resistance surveillance system has detected several outbreaks of quinolone-resistant gonococcal infections (QRNG), and sporadic treatment failures have been reported from high-incidence areas such as southeast Asia. QRNG may result from mutations that cause structural-functional changes in DNA topoisomerase (the quinolone target enzyme) or by changes in antimicrobial transport into the bacteria. QRNG has occurred sporadically in the United States, predominantly in persons with contact to persons in southeast Asia, and has typically occurred as an epiphenomenon in persons who were treated with other regimens. Nevertheless, this entity warrants close monitoring. The emergence of QRNG is probably related to antimicrobial misuse and overuse, in particular long-term suppressive or subtherapeutic doses.
自1989年以来，单剂量口服喹诺酮类药物一直被推荐用于淋病治疗。抗菌药物耐药性监测系统已检测到几起耐喹诺酮淋球菌感染（QRNG）疫情，东南亚等高发病率地区也报告了散发性治疗失败病例。QRNG可能是由导致DNA拓扑异构酶（喹诺酮类药物的靶酶）结构功能变化的突变引起的，也可能是由抗菌药物进入细菌的转运变化引起的。QRNG在美国偶有发生，主要发生在与东南亚人有接触的人群中，并且通常作为接受其他治疗方案的人的一种附带现象出现。然而，这个问题值得密切监测。QRNG的出现可能与抗菌药物的滥用和过度使用有关，特别是长期抑制性或亚治疗剂量。
