Llanes Rafael, Sosa Jorge, Guzmán Daymi, Llop Alina, Valdés Eduardo A, Martínez Isabel, Palma Sara, Lantero María I
Microbiology Branch, Tropical Medicine Institute Pedro Kourí, Havana, Cuba.
Sex Transm Dis. 2003 Jan;30(1):10-4. doi: 10.1097/00007435-200301000-00003.
Antibiotic-resistant strains of Neisseria gonorrhoeae, especially those resistant to penicillin and tetracycline, have spread with remarkable rapidity in many Caribbean countries.
The goal of the study was to survey the antibiotic susceptibilities of N gonorrhoeae strains isolated from 1995 to 1999 in Cuba and to discuss the impact of antimicrobial resistance on the management of gonorrhea in the country.
Susceptibility of the strains to penicillin, tetracycline, cefuroxime, ceftriaxone, ciprofloxacin, spectinomycin, and azithromycin were determined by an agar dilution method.
Penicillin and tetracycline resistance was noted in 60.8% and 54.2%, respectively, of the N gonorrhoeae strains tested. A total of 63.35 (76/120) of the N gonorrhoeae strains exhibited plasmid-mediated resistance to penicillin, tetracycline, or both. Strains with chromosomally mediated resistance to these antibiotics accounted for 10% (12/120) of the strains. The strains were susceptible to ceftriaxone, cefuroxime, spectinomycin, and ciprofloxacin. One strain's ciprofloxacin MIC was 0.125 mircog/ml. Of the 52 strains tested, 23.1% displayed intermediate resistance to azithromycin.
N gonorrhoeae strains exhibited a high frequency of resistance and multiresistance to penicillin and tetracycline. Therefore, these antibiotics should no longer be used to treat gonococcal infections in Cuba and should be substituted with effective drugs such as third-generation cephalosporins, spectinomycin, and fluoroquinolones. The detection of intermediate resistance to azithromycin and ciprofloxacin underlines the importance of periodic surveillance for susceptibility of N gonorrhoeae strains to antimicrobials agents used as primary therapy for gonorrhea.
淋病奈瑟菌的抗生素耐药菌株，尤其是对青霉素和四环素耐药的菌株，在许多加勒比国家迅速传播。
本研究的目的是调查1995年至1999年在古巴分离出的淋病奈瑟菌菌株的抗生素敏感性，并讨论抗菌药物耐药性对该国淋病治疗的影响。
采用琼脂稀释法测定菌株对青霉素、四环素、头孢呋辛、头孢曲松、环丙沙星、壮观霉素和阿奇霉素的敏感性。
在所检测的淋病奈瑟菌菌株中，分别有60.8%和54.2%对青霉素和四环素耐药。共有63.35%（76/120）的淋病奈瑟菌菌株表现出对青霉素、四环素或两者的质粒介导耐药。对这些抗生素具有染色体介导耐药性的菌株占菌株总数的10%（12/120）。这些菌株对头孢曲松、头孢呋辛、壮观霉素和环丙沙星敏感。一株菌株的环丙沙星最低抑菌浓度为0.125微克/毫升。在52株检测菌株中，23.1%对阿奇霉素表现出中度耐药。
淋病奈瑟菌菌株对青霉素和四环素表现出高耐药率和多重耐药性。因此，在古巴这些抗生素不应再用于治疗淋球菌感染，而应被有效药物如第三代头孢菌素、壮观霉素和氟喹诺酮类药物所替代。对阿奇霉素和环丙沙星中度耐药的检测凸显了定期监测淋病奈瑟菌菌株对用作淋病一线治疗的抗菌药物敏感性的重要性。
