Vorobieva Veronica, Firsova Natalia, Ababkova Tatiana, Leniv Ivan, Haldorsen Bjørg C, Unemo Magnus, Skogen Vegard
Department of Microbiology and Virology, University of Tromsø, Tromsø, Norway.
Sex Transm Infect. 2007 Apr;83(2):133-5. doi: 10.1136/sti.2006.021857. Epub 2006 Sep 13.
To characterise comprehensively the antibiotic susceptibility of Neisseria gonorrhoeae in Arkhangelsk, Russia, and to investigate whether the recommended treatment guidelines are updated and effective.
The susceptibility of N gonorrhoeae isolates, cultured during June-November 2004 mainly from consecutive patients with gonorrhoea (n = 76) in Arkhangelsk, to penicillin G, ampicillin, cefixime, ceftriaxone, ciprofloxacin, erythromycin, azithromycin, kanamycin, spectinomycin and tetracycline was analysed using Etest. Nitrocefin discs were used for beta-lactamase detection.
The levels of intermediate susceptibility and resistance to the different antibiotics were as follows: penicillin G 76%, ampicillin 71%, cefixime 0%, ceftriaxone 3%, ciprofloxacin 17%, erythromycin 54%, azithromycin 14%, kanamycin 49%, spectinomycin 0% and tetracycline 92%. Of the isolates 55 (72%) were determined as multiresistant--that is, they showed intermediate susceptibility or resistance to three or more classes of antibiotics. However, none of the isolates were beta-lactamase producing.
In Arkhangelsk, and presumably in many other areas of Russia, penicillins, ciprofloxacin, erythromycin, azithromycin, kanamycin and tetracycline should not be used in the treatment of gonorrhoea if the results of antibiotic susceptibility testing are not available. In Russia, optimised, standardised and quality-assured antibiotic susceptibility testing needs to be established in many laboratories. Subsequently, continuous local, regional and national surveillance of antibiotic susceptibility is crucial to detect the emergence of new resistance, monitor changing patterns of susceptibility and be able to update treatment recommendations on a regular basis.
全面描述俄罗斯阿尔汉格尔斯克地区淋病奈瑟菌的抗生素敏感性，并调查推荐的治疗指南是否及时更新且有效。
采用Etest法分析2004年6月至11月期间主要从阿尔汉格尔斯克连续的淋病患者（n = 76）中培养出的淋病奈瑟菌分离株对青霉素G、氨苄西林、头孢克肟、头孢曲松、环丙沙星、红霉素、阿奇霉素、卡那霉素、壮观霉素和四环素的敏感性。使用硝基头孢菌素纸片检测β-内酰胺酶。
对不同抗生素的中度敏感性和耐药性水平如下：青霉素G为76%，氨苄西林为71%，头孢克肟为0%，头孢曲松为3%，环丙沙星为17%，红霉素为54%，阿奇霉素为14%，卡那霉素为49%，壮观霉素为0%，四环素为92%。55株（72%）分离株被确定为多重耐药，即它们对三类或更多类抗生素表现出中度敏感性或耐药性。然而，所有分离株均不产β-内酰胺酶。
在阿尔汉格尔斯克以及俄罗斯许多其他地区，如果没有抗生素敏感性检测结果，不应使用青霉素、环丙沙星、红霉素、阿奇霉素、卡那霉素和四环素治疗淋病。在俄罗斯，许多实验室需要建立优化、标准化且质量有保证的抗生素敏感性检测。随后，持续进行局部、区域和国家层面的抗生素敏感性监测对于发现新的耐药性出现、监测敏感性变化模式以及能够定期更新治疗建议至关重要。
