Laboratório de Biologia Molecular, Microbiologia e Sorologia, Universidade Federal de Santa Catarina, Santa Catarina, Brazil; Programa de Pós-Graduação em Farmácia, Universidade Federal de Santa Catarina, Santa Catarina, Brazil.
Hospital Universitário, Universidade Federal de Santa Catarina, Empresa Brasileira de Serviços Hospitalares, Santa Catarina, Brazil.
J Microbiol Methods. 2022 Jun;197:106480. doi: 10.1016/j.mimet.2022.106480. Epub 2022 May 5.
Neisseria gonorrhoeae is a major concern of public health due to its extraordinary capacity to develop and acquire resistance to different antimicrobials used to treat gonorrhoea. Limited treatment options and uncontrolled transmission have raised the need to assess the antimicrobial susceptibility profile of the isolates and to establish affordable alternatives for laboratory diagnosis.
This study aimed to (i) determine the susceptibility profile of 336 clinical isolates of N. gonorrhoeae to ceftriaxone, azithromycin, ciprofloxacin, spectinomycin and gentamicin by the gold standard agar dilution method; (ii) assess the agreement among agar dilution and disc diffusion results for ciprofloxacin, azithromycin, ceftriaxone, spectinomycin and gentamicin.
All isolates were susceptible to ceftriaxone and spectinomycin. The levels of resistance to azithromycin and ciprofloxacin were 3.9% and 35.1%, respectively. Intermediate susceptibility to gentamicin was observed in 19.4% of isolates. There was 100% agreement between methods for spectinomycin and ceftriaxone, 99.7% for ciprofloxacin, and 85.7% for azithromycin. For gentamicin, there was 86.3% agreement between agar dilution and disc diffusion, resulting in intermediate susceptible by one method and susceptible by the other method, defined as minor errors. The discordance among agar dilution and disc diffusion results is acceptable for ciprofloxacin, ceftriaxone and spectinomycin as per CLSI M23-Ed4.
Spectinomycin and gentamicin can be considered in some cases as options for the treatment of gonorrhoea in Brazil. Disc diffusion can be an alternative method in routine testing with comparable accuracy to agar dilution.
淋病奈瑟菌由于其非凡的能力，能够对用于治疗淋病的不同抗菌药物产生耐药性和获得耐药性，因此成为公共卫生的一个主要关注点。有限的治疗选择和不受控制的传播增加了评估分离株抗菌敏感性谱的必要性，并为实验室诊断建立了负担得起的替代方法。
本研究旨在：(i)通过金标准琼脂稀释法测定 336 株淋病奈瑟菌临床分离株对头孢曲松、阿奇霉素、环丙沙星、壮观霉素和庆大霉素的敏感性谱；(ii)评估琼脂稀释法和纸片扩散法对环丙沙星、阿奇霉素、头孢曲松、壮观霉素和庆大霉素的结果的一致性。
所有分离株均对头孢曲松和壮观霉素敏感。对阿奇霉素和环丙沙星的耐药率分别为 3.9%和 35.1%。19.4%的分离株对庆大霉素呈中度敏感。壮观霉素和头孢曲松两种方法之间的一致性为 100%，环丙沙星为 99.7%，阿奇霉素为 85.7%。对于庆大霉素，琼脂稀释法和纸片扩散法之间的一致性为 86.3%，一种方法为中介敏感，另一种方法为敏感，定义为次要错误。根据 CLSI M23-Ed4，琼脂稀释法和纸片扩散法结果之间的不一致性可接受用于环丙沙星、头孢曲松和壮观霉素。
在巴西，大观霉素和庆大霉素可在某些情况下考虑作为淋病治疗的选择。纸片扩散法可作为常规检测的替代方法，其准确性与琼脂稀释法相当。
