Warren C, Phillips I
Department of Microbiology, St Thomas' Hospital, London, UK.
Genitourin Med. 1993 Jun;69(3):201-7. doi: 10.1136/sti.69.3.201.
To examine the penicillinase producing N. gonorrhoeae (PPNG) collected at St Thomas' Hospital from 1976-1990 and, by determination of antibiotic susceptibility pattern and application of three typing methods, examine the prevalence of different gonococcal types. Also to determine whether there is any relationship between antibiotic sensitivity, plasmid profile, auxotype and serovar.
A total of 665 isolates of PPNG from patients attending the Department of Genitourinary Medicine at St Thomas' Hospital were characterised by antibiotic MIC, plasmid profile, auxotyping and serotyping.
Penicillin MICs for 85% of all isolates were between 0.25 and 32 mg/l. The MIC of tetracycline for 60-80% of the isolates was < 1 mg/l. A small number of isolates had tetracycline MICs of 32 mg/l but MICs > 32 mg/l were not seen. Over 90% of the isolates were sensitive to the remaining three antibiotics tested, erythromycin, cefuroxime and spectinomycin. The 3.2 or 4.4 MDa plasmid with or without the 24.5 MDa conjugal plasmid was seen in all isolates until 1989/90 when a 2.9 MDa beta-lactamase encoding plasmid and the 25.2 MDa plasmid mediating tetracycline resistance were also recognised. Ninety-nine percent of all isolates belonged to one of four auxotypes, prototrophic, arginine, proline or proline/arginine requiring. An initial predominance of isolates with the 1A outer membrane protein was reversed in 1982 and 1B has remained predominant. Thirty two different serovars were identified among the 665 isolates, 14 belonged to serogroup 1A and 18 to 1B, and the eight most common accounted for 83.9% (554) of all isolates. Analysis of the results of combined typing methods showed there was an association between antibiotic resistance, plasmid profile and serogroup. The number of auxotypes and serovars detected in the collection, indicates the possibility that PPNG have been introduced from abroad or outside our local population.
Temporal trends in the distribution of auxotype/serovar classes show that the total population of PPNG isolates is formed by a heterogenous mixture in which certain auxotype/serovar classes appear, disappear and may re-emerge. Others were present throughout in small numbers.
检测1976年至1990年在圣托马斯医院收集的产青霉素酶淋病奈瑟菌（PPNG），通过测定抗生素敏感性模式并应用三种分型方法，检测不同淋球菌类型的流行情况。同时确定抗生素敏感性、质粒图谱、营养型和血清型之间是否存在任何关系。
对圣托马斯医院泌尿生殖医学科患者的665株PPNG分离株进行抗生素最低抑菌浓度（MIC）、质粒图谱、营养型分型和血清学分型鉴定。
所有分离株中85%的青霉素MIC在0.25至32mg/L之间。60 - 80%的分离株四环素MIC<1mg/L。少数分离株四环素MIC为32mg/L，但未见MIC>32mg/L的情况。超过90%的分离株对其余三种测试抗生素红霉素、头孢呋辛和壮观霉素敏感。直到1989/90年，所有分离株均可见携带或不携带24.5MDa接合质粒的3.2或4.4MDa质粒，此时还发现了编码β-内酰胺酶的2.9MDa质粒和介导四环素耐药性的25.2MDa质粒。所有分离株的99%属于四种营养型之一，即原养型、精氨酸需求型、脯氨酸需求型或脯氨酸/精氨酸需求型。1982年，最初以1A外膜蛋白为主的分离株情况发生逆转，此后1B一直占主导地位。在665株分离株中鉴定出32种不同血清型，14种属于血清群1A，18种属于1B，最常见的8种血清型占所有分离株的83.9%（554株）。综合分型方法结果分析表明，抗生素耐药性、质粒图谱和血清群之间存在关联。该收集样本中检测到的营养型和血清型数量表明，PPNG有可能是从国外或本地人群以外引入的。
营养型/血清型类别分布的时间趋势表明，PPNG分离株的总体由异质混合物组成，其中某些营养型/血清型类别出现、消失并可能再次出现。其他类型则一直少量存在。
