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在希腊分离的淋病奈瑟菌中,抗菌药物敏感性和血清型分布的变化情况。

Changing figures of antimicrobial susceptibility and serovar distribution in Neisseria gonorrhoeae isolated in Greece.

机构信息

National Reference Center for Neisseria gonorrhoeae, Laboratory of Bacteriology, Hellenic Pasteur Institute, Athens, Greece.

出版信息

Sex Transm Dis. 2010 Feb;37(2):115-20. doi: 10.1097/OLQ.0b013e3181bcd0b8.

DOI:10.1097/OLQ.0b013e3181bcd0b8
PMID:19901866
Abstract

OBJECTIVES

To update surveillance data on antimicrobial susceptibility of Neisseria gonorrhoeae isolated in Greece with information for the years 2005 to 2008, and analyze changes occurred from the previous 4-year period.

METHODS

Annual antimicrobial susceptibility rates, susceptibility patterns, and serovars of 635 gonococci isolated in 2005 to 2008 were determined and compared to respective data concerning the gonococcal sample of 2001 to 2004. Genetic similarity of the isolates in phenotypic clusters was investigated by pulsed field gel electrophoresis. Epidemiologic information was also considered.

RESULTS

Despite a reduction in the isolation frequency of penicillinase-producing strains (3.9% vs. 11.6% in the previous period), the rates of resistance and intermediate susceptibility increased for penicillin, as well as for tetracycline, erythromycin, and chloramphenicol, leaving very small proportions of isolates sensitive to these agents (4.3%, 12.8%, 10.2%, and 3.6%, respectively). Resistance to fluoroquinolones increased from 11.3% in 2004 up to 63% in 2008, and strongly correlated with multidrug-resistant isolates of Bropyst serovar, accounting for 72.6% of the quinolone-resistant strains isolated during the last 4 years. All isolates were susceptible to spectinomycin and only 2 exceeded susceptibility breakpoints set for cefotaxime, exhibiting MICs 0.75 to 1 microg/mL. These latter isolates, however, belonged to a cluster of strains with decreased susceptibility to cephalosporins (CDS, cefotaxime MICs >or=0.25 microg/mL) that emerged in late 2006 and increased in frequency up to 20.7% through 2008. Notably, CDS isolates were also quinolone-resistant and multiresistant, further contributing to the increasing rates of quinolone and multidrug resistance in the Greek gonococcal sample.

CONCLUSIONS

Antimicrobial susceptibility figures of Neisseria gonorrhoeae in Greece are worsening due to changes in the synthesis of gonococcal population, resulting from high endemicity rates of multidrug-resistant strains.

摘要

目的

更新希腊分离的淋病奈瑟菌对抗菌药物敏感性监测数据,包括 2005 年至 2008 年的数据,并分析与前一个 4 年相比发生的变化。

方法

测定了 2005 年至 2008 年分离的 635 株淋病奈瑟菌的年度抗菌药物敏感性率、药敏模式和血清型,并与 2001 年至 2004 年淋病奈瑟菌样本的相应数据进行比较。通过脉冲场凝胶电泳分析表型聚类中分离株的遗传相似性。还考虑了流行病学信息。

结果

尽管产青霉素酶菌株的分离频率降低(3.9%比前一时期的 11.6%),但青霉素、四环素、红霉素和氯霉素的耐药率和中介率均有所增加,对这些药物敏感的分离株比例很小(分别为 4.3%、12.8%、10.2%和 3.6%)。氟喹诺酮类药物的耐药率从 2004 年的 11.3%上升至 2008 年的 63%,与 Bropyst 血清型的多药耐药分离株密切相关,占过去 4 年分离的氟喹诺酮类耐药菌株的 72.6%。所有分离株均对大观霉素敏感,仅有 2 株超过头孢噻肟的药敏折点,MIC 值为 0.75 至 1μg/ml。然而,这些分离株属于头孢菌素敏感性降低(CDS,头孢噻肟 MIC 值>或=0.25μg/ml)的菌株簇,于 2006 年末出现并逐渐增多,至 2008 年增加到 20.7%。值得注意的是,CDS 分离株也对氟喹诺酮类药物耐药和多药耐药,进一步导致希腊淋球菌样本中氟喹诺酮类药物和多药耐药率的上升。

结论

由于高流行率的多药耐药菌株导致淋病奈瑟菌人群合成的变化,希腊淋病奈瑟菌对抗菌药物的敏感性数据正在恶化。

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