Kularatne Ranmini, Maseko Venessa, Gumede Lindy, Kufa Tendesayi
Centre for HIV & Sexually Transmitted Infections, National Institute for Communicable Diseases, Johannesburg 2131, South Africa.
Department of Clinical Microbiology & Infectious Diseases, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2195, South Africa.
Antibiotics (Basel). 2018 Jul 12;7(3):58. doi: 10.3390/antibiotics7030058.
In South Africa, sexually transmitted infections (STIs) are managed through a syndromic approach at primary healthcare centres (PHCs). is the predominant cause of male urethritis syndrome. We describe antimicrobial resistance patterns and trends in during a ten-year surveillance period at a large PHC in Johannesburg.
was cultured from genital discharge swab specimens obtained from consenting adult patients presenting at the Alexandra Health Centre in Johannesburg between 2008 and 2017. Isolates were tested for antimicrobial susceptibility by Etest™ (cefixime, ceftriaxone, ciprofloxacin) or agar dilution (penicillin, tetracycline, azithromycin).
During the period of surveillance, high-level resistance prevalence increased from 30% to 51% for penicillin (-value for trend < 0.001), 75% to 83% for tetracycline (-value for trend = 0.008), and 25% to 69% for ciprofloxacin (-value for trend < 0.001). Analysis did not reveal high-level resistance to spectinomycin or a minimum inhibitory concentration (MIC) creep for extended-spectrum cephalosporins, and the prevalence of intermediate-resistance to azithromycin was less than 5%.
High prevalence resistance to penicillin, tetracycline, and ciprofloxacin in obviates their use in future national treatment algorithms for genital discharge. It is essential to continue monitoring for emerging resistance to currently recommended antimicrobial therapy in this rapidly evolving pathogen.
在南非，性传播感染（STIs）在初级医疗保健中心（PHCs）通过症状诊断方法进行管理。淋病奈瑟菌是男性尿道炎综合征的主要病因。我们描述了约翰内斯堡一家大型初级医疗保健中心在十年监测期内淋病奈瑟菌的抗菌药物耐药模式及趋势。
从2008年至2017年期间在约翰内斯堡亚历山德拉健康中心就诊并同意参与的成年患者的生殖器分泌物拭子标本中培养淋病奈瑟菌。采用Etest™（头孢克肟、头孢曲松、环丙沙星）或琼脂稀释法（青霉素、四环素、阿奇霉素）对分离菌株进行抗菌药物敏感性测试。
在监测期间，青霉素的高水平耐药率从30%升至51%（趋势P值<0.001），四环素从75%升至83%（趋势P值=0.008），环丙沙星从25%升至69%（趋势P值<0.001）。分析未发现对壮观霉素的高水平耐药或超广谱头孢菌素的最低抑菌浓度（MIC）缓慢上升，对阿奇霉素的中介耐药率低于5%。
淋病奈瑟菌对青霉素、四环素和环丙沙星的高耐药率使其无法用于未来全国性的生殖器分泌物治疗方案。对于这种快速演变的病原体，持续监测对当前推荐抗菌治疗新出现的耐药情况至关重要。
