Van Dyck E, Karita E, Abdellati S, Dirk V H, Ngabonziza M, Lafort Y, Laga M
Institute of Tropical Medicine, Antwerp, Belgium.
Sex Transm Dis. 2001 Sep;28(9):539-45. doi: 10.1097/00007435-200109000-00012.
Plasmid-mediated and chromosomal-mediated resistance of Neisseria gonorrhoeae to penicillin, tetracycline, thiamphenicol, and trimethoprim-sulfamethoxazole has spread dramatically in Africa. Monitoring of antimicrobial susceptibility is a key element in the control of sexually transmitted diseases.
To document antimicrobial susceptibilities of gonococci isolated during the past 15 years in Kigali, Rwanda.
Minimal inhibitory concentrations of recently collected gonococcal isolates of eight antimicrobials were determined. The results were compared with data collected for isolates obtained since 1986.
In 1986, 35% of the gonococcal isolates were penicillinase-producing N gonorrhoeae. Tetracycline-resistant N gonorrhoeae appeared in 1989. The prevalence of penicillinase-producing N gonorrhoeae and tetracycline-resistant N gonorrhoeae increased significantly to 70.5% and 89.2%, respectively. Chromosomal resistance to penicillin, tetracycline, and thiamphenicol increased temporarily, then decreased significantly. Chromosomal resistance to trimethoprim-sulfamethoxazole appeared in 1988 and increased to 21.6%. All the isolates were susceptible to ceftriaxone, ciprofloxacin, spectinomycin, and kanamycin.
This study illustrated the rapidly increasing frequencies of penicillinase-producing N gonorrhoeae and tetracycline-resistant N gonorrhoeae. Chromosomal resistance to thiamphenicol and trimethoprim-sulfamethoxazole excludes these drugs as alternative treatment. Programs for antimicrobial susceptibility surveillance of N gonorrhoeae should urgently be established in Africa.
淋病奈瑟菌对青霉素、四环素、甲砜霉素和甲氧苄啶 - 磺胺甲恶唑的质粒介导和染色体介导耐药性在非洲已急剧蔓延。抗菌药物敏感性监测是控制性传播疾病的关键要素。
记录过去15年在卢旺达基加利分离出的淋病奈瑟菌的抗菌药物敏感性。
测定了最近收集的淋病奈瑟菌分离株对8种抗菌药物的最低抑菌浓度。将结果与1986年以来收集的分离株数据进行比较。
1986年，35%的淋病奈瑟菌分离株为产青霉素酶淋病奈瑟菌。耐四环素淋病奈瑟菌于1989年出现。产青霉素酶淋病奈瑟菌和耐四环素淋病奈瑟菌的患病率分别显著增加至70.5%和89.2%。对青霉素、四环素和甲砜霉素的染色体耐药性暂时增加，然后显著下降。对甲氧苄啶 - 磺胺甲恶唑的染色体耐药性于1988年出现并增至21.6%。所有分离株对头孢曲松、环丙沙星、壮观霉素和卡那霉素敏感。
本研究表明产青霉素酶淋病奈瑟菌和耐四环素淋病奈瑟菌的频率迅速增加。对甲砜霉素和甲氧苄啶 - 磺胺甲恶唑的染色体耐药性排除了将这些药物作为替代治疗的可能性。应在非洲紧急建立淋病奈瑟菌抗菌药物敏感性监测项目。
