Serra-Pladevall Judit, Barberá-Gracia María Jesús, Roig-Carbajosa Glòria, Juvé-Saumell Rosa, Gonzalez-Lopez Juan José, Bartolomé-Comas Rosa, Andreu-Domingo Antònia
Servei de Microbiología, Hospital Universitari Vall d'Hebron, Barcelona, España.
Enferm Infecc Microbiol Clin. 2013 Nov;31(9):579-83. doi: 10.1016/j.eimc.2013.03.010. Epub 2013 Apr 25.
Due to the high rates of antimicrobial resistance to certain antibiotics, together with the emergence of Neisseria gonorrhoeae (NG) with reduced susceptibility and resistance to third-generation cephalosporins, gonococcal infection is becoming a public health problem. The objectives of the study were: To keep track of the antimicrobial susceptibility of NG strains obtained from January to August 2011. To study the population dynamics.
The antimicrobial susceptibility was studied by disk-diffusion and E-test. The genotyping was performed by NG-MAST method.
Of a total of 100strains studied, 59% showed intermediate sensitivity to penicillin and 9% were resistant. According to EUCAST, we detected 3gonococci with reduced susceptibility to ceftriaxone, 10 to cefixime and one with high-level resistance to both antibiotics (MIC 1.5μg/ml). MIC50 and MIC90 to cefixime were 0.016 and 0.125μg/ml, respectively, whereas to ceftriaxone they were <0.016 and 0.064μg/ml, respectively. Almost all (99%) of the strains were resistant to doxycycline, 53% to ciprofloxacin, 3% to azithromycin, and 1% to spectinomycin. The most prevalent ST was ST1407, predominantly associated to resistance or reduced sensitivity to cephalosporins or macrolides.
NG has developed significant rates of resistance to various antibiotics. One strain has been detected with high level resistance to third generation cephalosporins, and several strains with reduced susceptibility. An increase in MIC50 and MIC90 to these antibiotics has also been observed. NG population structure remains stable and common to the rest of Europe, although two new ST (ST7226 and ST7227) have been identified that could be selected and acquire high levels of resistance to cephalosporins.
由于某些抗生素的耐药率较高，加之出现了对第三代头孢菌素敏感性降低和耐药的淋病奈瑟菌（NG），淋球菌感染正成为一个公共卫生问题。本研究的目的是：追踪2011年1月至8月期间分离得到的NG菌株的抗菌药物敏感性。研究群体动态。
采用纸片扩散法和E试验研究抗菌药物敏感性。采用NG-MAST方法进行基因分型。
在总共研究的100株菌株中，59%对青霉素表现出中度敏感性，9%耐药。根据欧洲抗菌药物敏感性试验委员会（EUCAST）的标准，我们检测到3株对头孢曲松敏感性降低的淋球菌，10株对头孢克肟敏感性降低的淋球菌，以及1株对这两种抗生素均具有高水平耐药性的菌株（最低抑菌浓度[MIC]为1.5μg/ml）。头孢克肟的MIC50和MIC90分别为0.016和0.125μg/ml，而头孢曲松的MIC50和MIC90分别<0.016和0.064μg/ml。几乎所有（99%）的菌株对多西环素耐药，53%对环丙沙星耐药，3%对阿奇霉素耐药，1%对大观霉素耐药。最常见的序列型（ST）是ST1407，主要与对头孢菌素或大环内酯类药物的耐药性或敏感性降低有关。
NG已对多种抗生素产生了显著的耐药率。检测到1株对第三代头孢菌素有高水平耐药性的菌株，以及几株敏感性降低的菌株。还观察到这些抗生素的MIC50和MIC90有所增加。NG的群体结构保持稳定，与欧洲其他地区相同，尽管已鉴定出两个新的ST（ST7226和ST7227），它们可能会被选择并获得对头孢菌素的高水平耐药性。
