School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Division of General Medicine, Department of Medical Education, Shin Kong Wu Ho-Su Memorial Hospital, Taiwan.
Fengshan Li Jiawen Urology Clinic, Kaohsiung, Taiwan.
J Microbiol Immunol Infect. 2023 Aug;56(4):833-841. doi: 10.1016/j.jmii.2023.03.005. Epub 2023 Mar 21.
BACKGROUND/PURPOSE: Multi-drug resistance and the presence of epidemic lineages of Neisseria gonorrhoeae locally and globally were important clinical and public health issues. We aimed to investigate the molecular epidemiology and the antimicrobial susceptibility profiles of N. gonorrhoeae in Southern Taiwan.
Between 2019 and 2021, adult patients who had suspected gonorrhea and attended a urology clinic in southern Taiwan were recruited to participate in this study. Clinical data from medical records and a questionnaire, antimicrobial susceptibility testing using a disk diffusion test in accordance with the guidelines by the Clinical and Laboratory Standards Institute, and Multi-locus sequence typing (MLST) were analyzed.
A total of 500 patients participated in the surveillance study. Among them, 232 N. gonorrhoeae isolates were identified, but only 164 isolates were recovered for further research. ST7363 (n = 83, 50.61%) was found to be the predominant sequence type, followed by ST1583 (n = 24, 14.63%), ST1588 (n = 13, 7.93%), and ST7827 (n = 12, 7.32%). 100% resistance to penicillin and 99.4% non-susceptible rate of ciprofloxacin were observed. The azithromycin resistant rate being 15.24% and the cefixime non-susceptible rate being 17.07% were alarming, both with decreasing trends in susceptibilities during 2019-2021. The 25 azithromycin resistant isolates were mainly belonged to ST7363 (n = 12) and ST7827 (n = 3). Seven (4.2%) isolates were ceftriaxone non-susceptible. Among them, four were assigned to be ST 7827 and three belonged to ST7363.
We observed the emergence of a predominant sequence type ST7363 in southern Taiwan. Compared with previous Taiwan studies, the increasing trend of resistance to cefixime and ceftriaxone necessitates clinicians' alertness for clinical treatment response of the extended spectrum cephalosporins and the further surveillance monitor.
背景/目的：耐多药和淋病奈瑟菌流行谱系的存在在本地和全球都是重要的临床和公共卫生问题。我们旨在调查台湾南部淋病奈瑟菌的分子流行病学和抗生素敏感性特征。
2019 年至 2021 年间，在台湾南部的泌尿科诊所就诊并怀疑患有淋病的成年患者被招募参加了这项研究。分析了病历和问卷调查中的临床数据、根据临床和实验室标准协会指南进行的抗生素药敏试验（使用纸片扩散试验）和多位点序列分型（MLST）。
共有 500 名患者参加了监测研究。其中，鉴定出 232 株淋病奈瑟菌分离株，但仅回收了 164 株进行进一步研究。ST7363（n=83，50.61%）是主要的序列型，其次是 ST1583（n=24，14.63%）、ST1588（n=13，7.93%）和 ST7827（n=12，7.32%）。青霉素 100%耐药，环丙沙星 99.4%非敏感性。阿奇霉素耐药率为 15.24%，头孢克肟不敏感率为 17.07%，均呈下降趋势。25 株阿奇霉素耐药株主要属于 ST7363（n=12）和 ST7827（n=3）。7 株（4.2%）分离株对头孢曲松不敏感。其中，4 株被鉴定为 ST7827，3 株属于 ST7363。
我们观察到 ST7363 主要序列型在台湾南部的出现。与之前的台湾研究相比，头孢克肟和头孢曲松的耐药性增加趋势需要临床医生警惕对扩展谱头孢菌素的临床治疗反应，并进一步进行监测监测。
