Johnson S R, Morse S A
Sexually Transmitted Diseases Laboratory Program, Centers for Disease Control, Atlanta, GA 30333.
Sex Transm Dis. 1988 Oct-Dec;15(4):217-24. doi: 10.1097/00007435-198810000-00008.
In recent years the emergence and spread of antibiotic resistance in Neisseria gonorrhoeae has increased markedly. Chromosomal resistance to penicillin and tetracycline is due to the effects of one or more mutations and is generally low-level. However, the effects of these mutations are additive. Thus, the level of resistance in strains with several mutations is often high enough to yield significant rates of treatment failure. Resistance to aminoglycosides (e.g., streptomycin and kanamycin) and spectinomycin, an aminocyclitol antibiotic is not due to the inactivation of the antibiotic but to an alteration in the sensitivity of the 30S ribosomal subunit to the drug. At least five beta-lactamase plasmids of N. gonorrhoeae have been described. Some of these plasmids can be mobilized by the 24.5-MDa gonococcal conjugative plasmid and transferred to other gonococcal strains. Gonococci have recently acquired high-level resistance to tetracycline due to the streptococcal tetM determinant. This determinant is located on a 25.2-MDa plasmid that possesses a considerable degree of homology with the 24.5-MDa conjugative plasmid. The 25.2-MDa plasmid has retained the ability to transfer beta-lactamase plasmids as well as to mobilize and transfer itself to suitable recipient strains.
近年来，淋病奈瑟菌中抗生素耐药性的出现和传播显著增加。对青霉素和四环素的染色体耐药性是由一个或多个突变的影响导致的，通常为低水平耐药。然而，这些突变的影响具有累加性。因此，具有多个突变的菌株中的耐药水平往往高到足以导致显著的治疗失败率。对氨基糖苷类抗生素（如链霉素和卡那霉素）和大观霉素（一种氨基环醇类抗生素）的耐药性并非由于抗生素失活，而是由于30S核糖体亚基对药物的敏感性发生改变。已描述了至少五种淋病奈瑟菌的β-内酰胺酶质粒。其中一些质粒可被24.5-MDa淋病奈瑟菌接合质粒动员，并转移至其他淋病奈瑟菌菌株。由于链球菌tetM决定簇，淋病奈瑟菌最近获得了对四环素的高水平耐药性。该决定簇位于一个25.2-MDa质粒上，该质粒与24.5-MDa接合质粒具有相当程度的同源性。25.2-MDa质粒保留了转移β-内酰胺酶质粒的能力，以及将自身动员并转移至合适受体菌株的能力。
