National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada.
Sex Transm Dis. 2011 Oct;38(10):892-8. doi: 10.1097/OLQ.0b013e31822c664f.
Canada conducts surveillance of penicillin, tetracycline, erythromycin, spectinomycin, ciprofloxacin, cefixime, and ceftriaxone susceptibilities in Neisseria gonorrhoeae isolates to support development of national treatment guidelines for sexually transmitted infections.
N. gonorrhoeae isolates were collected by Canadian provincial public health laboratories and included isolates from males and females ranging in age from 1 to 86 years. Minimum inhibitory concentrations (MICs) were determined by agar dilution at the National Microbiology Laboratory, Public Health Agency of Canada, and MIC interpretations were based on the criteria of the Clinical Laboratory Standards Institute.
From 2000 to 2009, 40,875 isolates of N. gonorrhoeae were tested by provincial laboratories and 10,993 of these were characterized by the Public Health Agency of Canada. There was an increasing incidence of N. gonorrhoeae isolates that were chromosomally resistant to penicillin, tetracycline, and erythromycin while the plasmid-mediated resistance strains (penicillinase-producing N. gonorrhoeae, tetracycline-resistant N. gonorrhoeae, and PP/tetracycline-resistant N. gonorrhoeae strain all had a declining trend. The percentage of isolates resistant to ciprofloxacin significantly increased from 1.3% in 2000 to 25.5% in 2009. Only 0.17% of isolates tested were azithromycin resistant. Between 2000 and 2009, the modal MICs for ceftriaxone increased from 0.016 μg/mL to 0.063 μg/mL.
Ciprofloxacin resistance in N. gonorrhoeae within Canada has increased to a level where quinolones are no longer the preferred drugs for the treatment of gonococcal infections and the modal MICs for the third-generation cephalosporins have increased over time. Close monitoring of antibiotic susceptibilities are required to inform treatment options.
加拿大对淋病奈瑟菌分离株中的青霉素、四环素、红霉素、大观霉素、环丙沙星、头孢克肟和头孢曲松的敏感性进行监测，以支持制定国家性传播感染治疗指南。
加拿大省级公共卫生实验室收集淋病奈瑟菌分离株，包括年龄在 1 至 86 岁的男性和女性分离株。在加拿大公共卫生局国家微生物学实验室通过琼脂稀释法测定最小抑菌浓度（MIC），并根据临床实验室标准协会的标准进行 MIC 解释。
2000 年至 2009 年，省级实验室共检测了 40875 株淋病奈瑟菌分离株，其中加拿大公共卫生局对 10993 株进行了特征描述。对青霉素、四环素和红霉素的染色体耐药淋病奈瑟菌分离株的发生率呈上升趋势，而质粒介导的耐药菌株（产青霉素酶淋病奈瑟菌、四环素耐药淋病奈瑟菌和 PP/四环素耐药淋病奈瑟菌株）均呈下降趋势。对环丙沙星的耐药分离株百分比从 2000 年的 1.3%显著增加到 2009 年的 25.5%。只有 0.17%的分离株对阿奇霉素耐药。2000 年至 2009 年间，头孢曲松的 MIC50 值从 0.016 μg/ml 增加到 0.063 μg/ml。
加拿大淋病奈瑟菌对环丙沙星的耐药性已增加到喹诺酮类药物不再是治疗淋病奈瑟菌感染的首选药物的程度，且第三代头孢菌素的 MIC50 值随时间推移而增加。需要密切监测抗生素敏感性，以提供治疗选择。
