2000年至2012年中国南宁淋病奈瑟菌抗菌药物敏感性监测

Surveillance of antimicrobial susceptibilities of Neisseria gonorrhoeae in Nanning, China, 2000 to 2012.

作者信息

Zhu Bang-yong, Yu Rui-xing, Yin Yueping, Chen Xiangsheng, Li Wei, Dai Xiu-qin, Liang Ming, Gan Quan, Huang Yan-jie, Wei Jiang-ping

机构信息

From the *Institute of Dermatology, Guangxi Autonomous Region, Nanning, China; †Reference STD Lab, National Center for STD Control, Chinese CDC, and Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, and Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Nanjing, Jiangsu Province, China; and ‡The First Affiliated Hospital of Guangxi Medical University, Institute of Dermatology, Nanning, China.

出版信息

Sex Transm Dis. 2014 Aug;41(8):501-6. doi: 10.1097/OLQ.0000000000000157.

DOI:10.1097/OLQ.0000000000000157

PMID:25013979

Abstract

OBJECTIVES

To monitor the frequency of antibiotic resistance of Neisseria gonorrhoeae (NG) in Nanning, China, between 2000 and 2012.

METHODS

The production of β-lactamase by NG isolates was determined using the paper acidometric testing method. Antimicrobial susceptibility testing was performed for tetracycline, ciprofloxacin, spectinomycin, and ceftriaxone using the agar dilution method. The χ(2) test, t test, and univariate and multivariate analyses were used to analyze the statistical difference of the results.

RESULTS

A total of 923 NG isolates were collected in Nanning between 2000 and 2012. Among these, 131 (14.2%) were penicillinase-producing NG, 520 (56.3%) isolates were tetracycline-resistant NG, and 857 (92.9%) isolates were ciprofloxacin-resistant strains. One spectinomycin-resistant strain was identified in 2000. There were 304 (32.9%) isolates with decreased susceptibility to ceftriaxone; the proportion of such isolates increased from 22.8% in 2000 to 2002 to 48.9% in 2006 to 2008 (P < 0.001), followed by a fall to 32.2% in 2009 to 2012 (P = 0.001). Patients' age of 16 to 25 years and isolate collection period of 2008 to 2012 (except 2011) were demonstrated to be risk factors for infection with isolates with decreased susceptibility to ceftriaxone.

CONCLUSIONS

Antimicrobial susceptibility of NG isolates obtained from patients in Nanning from 2000 to 2012 was characterized by high occurrence of penicillinase-producing NG, tetracycline-resistant NG, and ciprofloxacin-resistant strains. Spectinomycin and ceftriaxone can be considered drugs of choice for empirical treatment of NG infection in Nanning. Moreover, we recommend a combination of 500 mg or higher dose of intramuscular ceftriaxone and 1 g oral azithromycin be used for the treatment of NG infection in Nanning and possibly in China.

摘要

目的

监测2000年至2012年中国南宁淋病奈瑟菌（NG）的抗生素耐药频率。

方法

采用试纸酸度法检测NG分离株β-内酰胺酶的产生情况。采用琼脂稀释法对四环素、环丙沙星、壮观霉素和头孢曲松进行药敏试验。采用χ²检验、t检验以及单因素和多因素分析来分析结果的统计学差异。

结果

2000年至2012年期间在南宁共收集到923株NG分离株。其中，131株（14.2%）为产青霉素酶的NG，520株（56.3%）分离株对四环素耐药，857株（92.9%）分离株对环丙沙星耐药。2000年鉴定出1株对壮观霉素耐药的菌株。有304株（32.9%）分离株对头孢曲松的敏感性降低；此类分离株的比例从2000年至2002年的22.8%增加到2006年至2008年的48.9%（P<0.001），随后在2009年至2012年降至32.2%（P=0.001）。16至25岁的患者以及2008年至2012年（2011年除外）的分离株收集期被证明是感染对头孢曲松敏感性降低的分离株的危险因素。

结论

2000年至2012年从南宁患者中分离出的NG分离株的药敏特征为产青霉素酶的NG、对四环素耐药的NG和对环丙沙星耐药的菌株发生率高。壮观霉素和头孢曲松可被视为南宁NG感染经验性治疗的首选药物。此外，我们建议使用500mg或更高剂量的肌内注射头孢曲松与1g口服阿奇霉素联合用于南宁乃至中国的NG感染治疗。