Kam K M, Wong P W, Cheung M M, Ho N K, Lo K K
Public Health Laboratory, Sai Ying Pun Polyclinic, Hong Kong.
Sex Transm Dis. 1996 Mar-Apr;23(2):103-8. doi: 10.1097/00007435-199603000-00003.
To study the serologic characters and antibiotic susceptibilities of quinolone-resistant Neisseria gonorrhoeae in Hong Kong.
Sixty-nine strains of Neisseria gonorrhoeae isolated from clinical failure cases after treatment with ofloxacin during the period January 1, 1992, to January 1, 1995, were studied. A panel of 14 monoclonal antibodies against protein I classified these strains into 21 serovars. The pattern of serovar distribution against varying minimum inhibitory concentrations of ofloxacin was compared with 143 strains isolated from a cohort of quinolone-susceptible, clinically responsive cases. Antibiotic susceptibilities tests were performed on quinolone-resistant strains to penicillin, tetracycline, ciprofloxacin, spectinomycin, and ceftriaxone. Epidemiologic information on location of contact was collected.
Serologic characterization showed that Bop and Bpy were the dominant serovars among quinolone-resistant strains. Most IA and other IB serovars had declined in the selection process for quinolone resistance. Antibiotic susceptibility tests showed that 81.2%, 89.9%, and 78.3% of quinolone-resistant Neisseria gonorrhoeae strains were resistant to penicillin, tetracycline, and both, respectively, whereas 10 of 69 (14.5%) of such strains displayed high-level quinolone resistance (ofloxacin minimum inhibitory concentration > 8 micrograms/ml). The quinolone-resistant strains remained fully susceptible to spectinomycin and ceftriaxone.
Quinolone-resistant strains have become firmly established in Hong Kong. Serovar determination has documented shifts in the gonococcal population during the selection process for quinolone resistance. Places that use quinolones in the treatment of sexually transmitted diseases should be alert to the emergence of high-level quinolone-resistant Neisseria gonorrhoeae.
研究香港耐喹诺酮淋病奈瑟菌的血清学特征及抗生素敏感性。
对1992年1月1日至1995年1月1日期间，经氧氟沙星治疗临床失败病例中分离出的69株淋病奈瑟菌进行研究。一组针对蛋白I的14种单克隆抗体将这些菌株分为21个血清型。将这些菌株针对不同氧氟沙星最低抑菌浓度的血清型分布模式，与从一组喹诺酮敏感、临床有反应病例中分离出的143株菌株进行比较。对耐喹诺酮菌株进行青霉素、四环素、环丙沙星、壮观霉素和头孢曲松的抗生素敏感性试验。收集接触地点的流行病学信息。
血清学特征显示，Bop和Bpy是耐喹诺酮菌株中的主要血清型。在喹诺酮耐药的选择过程中，大多数IA和其他IB血清型有所减少。抗生素敏感性试验表明，81.2%、89.9%和78.3%的耐喹诺酮淋病奈瑟菌菌株分别对青霉素、四环素及两者均耐药，而69株中的10株（14.5%）此类菌株表现出高水平喹诺酮耐药（氧氟沙星最低抑菌浓度>8微克/毫升）。耐喹诺酮菌株对壮观霉素和头孢曲松仍完全敏感。
耐喹诺酮菌株在香港已牢固确立。血清型测定记录了喹诺酮耐药选择过程中淋球菌群体的变化。在性传播疾病治疗中使用喹诺酮类药物的地方应警惕高水平耐喹诺酮淋病奈瑟菌的出现。
