Edmonton STI Clinic, Alberta Health Services, Edmonton, Alberta, Canada.
Sex Transm Dis. 2013 Sep;40(9):744-50. doi: 10.1097/01.olq.0000431356.80840.d4.
Antimicrobial resistance testing and behavioral data combined with Neisseria gonorrhoeae multiantigen sequence typing (NG-MAST) can help to define gonococcal populations and identify, characterize, and compare clusters of infection.
Antimicrobial resistance testing, using E test, was reviewed for gonococcal isolates in Alberta, Canada, from 2007 to 2011. Antimicrobial resistance testing was conducted on isolates demonstrating antimicrobial resistance and those with cefixime minimum inhibitory concentrations (MICs) of 0.06 μg/mL or greater. Demographic and behavioral information was obtained from provincial surveillance data. NG-MAST typing was conducted on a proportion of isolates.
Gonococcal isolates were available for 2250 (26.4%) of 8535 cases of gonorrhea in Alberta from 2007 to 2011. The proportion of cases with decreased susceptibility to cefixime (≥0.06 μg/mL) increased from 0.7% to 2.4% between 2007 and 2009 to a high of 10.1% in 2010 and 8.9% in 2011. Six isolates with cefixime MIC of 0.25 μg/mL were noted: 5 were from men who have sex with men (MSM) and 1 was a pharyngeal isolate from a heterosexual female. Twenty-four (1.1%) isolates were azithromycin resistant (MIC ≥2.0 μg/mL); there were no significant differences between cases resistant or susceptible to azithromycin. NG-MAST of gonococcal isolates in Alberta suggests the entry of multiple strains into the province. Three clusters were identified: Cluster A predominantly in MSM, including sequence type 1407, a ST previously associated with decreased susceptibility to expanded spectrum cephalosporins; Cluster B, a predominantly heterosexual cluster with most cases in Edmonton; and Cluster C among MSM.
Our data highlight the use of NG-MAST in further defining gonococcal populations.
抗菌药物耐药性检测与行为数据相结合，再加上淋病奈瑟菌多位点序列分型（NG-MAST），有助于确定淋球菌群体，并识别、描述和比较感染群。
对 2007 年至 2011 年加拿大艾伯塔省的淋病奈瑟菌分离株进行了 E 试验法的抗菌药物耐药性检测。对表现出抗菌药物耐药性的分离株以及头孢克肟最小抑菌浓度（MIC）≥0.06μg/ml 的分离株进行了抗菌药物耐药性检测。从省级监测数据中获取人口统计学和行为学信息。对部分分离株进行了 NG-MAST 分型。
2007 年至 2011 年，艾伯塔省 8535 例淋病病例中，有 2250 例（26.4%）提供了淋球菌分离株。头孢克肟（≥0.06μg/ml）中介率从 2007 年至 2009 年的 0.7%上升至 2010 年的 10.1%和 2011 年的 8.9%。发现 6 株头孢克肟 MIC 为 0.25μg/ml 的分离株：5 株来自男男性行为者（MSM），1 株为异性恋女性咽部分离株。24 株（1.1%）对阿奇霉素耐药（MIC≥2.0μg/ml）；对阿奇霉素耐药或敏感的病例之间无显著差异。艾伯塔省淋球菌分离株的 NG-MAST 表明，有多种菌株进入该省。确定了 3 个群：群 A 主要存在于 MSM 中，包括以前与广谱头孢菌素耐药性降低相关的 1407 型序列型；群 B 是一个主要存在于异性恋人群的集群，大多数病例发生在埃德蒙顿；群 C 则存在于 MSM 中。
我们的数据突出了 NG-MAST 在进一步确定淋球菌群体中的应用。
