Martin I, Sawatzky P, Liu G, Mulvey M R
National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB.
Can Commun Dis Rep. 2015 Feb 5;41(2):35-41. doi: 10.14745/ccdr.v41i02a04.
Gonorrhea is on the rise in Canada. Treatment has been complicated by the fact that has acquired resistance to many antibiotics, including penicillin, tetracycline, erythromycin and ciprofloxacin. The emergence of isolates with decreased susceptibilities to the third generation cephalosporins and reports of treatment failures in Canada and around the world are cause for concern.
To assess the resistance levels of common antibiotics to and to observe trends in resistance and/or decreased susceptibility to ciprofloxacin, third generation cephalosporins and azithromycin.
Laboratory surveillance data for isolates submitted by provincial microbiology laboratories to the National Microbiology Laboratory (NML) from 2009-2013 were compared.
Since 2009, there has been an overall rise in antibiotic-resistant . In 2013, 24.3% of the isolates were resistant to erythromycin, 18.9% were resistant to penicillin, 33.0% were resistant to tetracycline, and 29.3% were resistant to ciprofloxacin. The percentage of isolates with decreased susceptibility to ceftriaxone (≥0.125 mg/L) and/or cefixime (≥0.25 mg/L) was 3.9% in 2013. This number represents a decrease from 5.9% in 2012 and 7.6% in 2011. The proportion of azithromycin resistant (MIC ≥2 mg/L) isolates increased from 0.4% in 2009 to 1.2% in 2013.
Resistance to erythromycin, penicillin, tetracycline and ciprofloxacin is common. Decreased susceptibility to ceftriaxone and/or cefixime is now almost 4% and azithromycin resistance is emerging but remains low at 1.2%. These results have informed the gonococcal infection treatment recommendations in the Canadian Guidelines on Sexually Transmitted Infections.
淋病在加拿大呈上升趋势。由于淋病已对包括青霉素、四环素、红霉素和环丙沙星在内的多种抗生素产生耐药性，治疗变得复杂。在加拿大及世界各地，对第三代头孢菌素敏感性降低的菌株的出现以及治疗失败的报告令人担忧。
评估常见抗生素对淋病奈瑟菌的耐药水平，并观察对环丙沙星、第三代头孢菌素和阿奇霉素的耐药性和/或敏感性降低的趋势。
比较了2009年至2013年省级微生物实验室提交给国家微生物实验室（NML）的淋病奈瑟菌分离株的实验室监测数据。
自2009年以来，耐抗生素淋病奈瑟菌总体呈上升趋势。2013年，24.3%的分离株对红霉素耐药，18.9%对青霉素耐药，33.0%对四环素耐药，29.3%对环丙沙星耐药。2013年，对头孢曲松（≥0.125mg/L）和/或头孢克肟（≥0.25mg/L）敏感性降低的分离株百分比为3.9%。这一数字低于2012年的5.9%和2011年的7.6%。阿奇霉素耐药（MIC≥2mg/L）淋病奈瑟菌分离株的比例从2009年的0.4%增至2013年的1.2%。
对红霉素、青霉素、四环素和环丙沙星耐药很常见。对头孢曲松和/或头孢克肟敏感性降低的比例目前接近4%，阿奇霉素耐药性正在出现，但仍较低，为1.2%。这些结果为《加拿大性传播感染指南》中的淋球菌感染治疗建议提供了依据。
