Bogaerts J, Van Dyck E, Mukantabana B, Munyabikali J P, Martinez Tello W
Centre Hospitalier de Kigali, Rwanda.
Sex Transm Infect. 1998 Jun;74(3):205-9. doi: 10.1136/sti.74.3.205.
To investigate the in vitro antimicrobial susceptibility and the auxotype/serovar distribution of Neisseria gonorrhoeae in Kigali, Rwanda, during 1985-93.
As part of a monitoring programme the in vitro susceptibility of 1604 isolates of N gonorrhoeae was determined by agar dilution. Auxo- and serotyping was performed on 1350 and 1313 isolates respectively.
The prevalence of penicillinase producing N gonorrhoeae (PPNG) remained stable at a rate of 39% during 1985-91 and increased to 61% in 1992-3. Chromosomal resistance to penicillin was common among non-PPNG and resistance to thiamphenicol and tetracycline was common among both PPNG and non-PPNG. High level, plasmid mediated resistance to tetracycline (TRNG) was observed for the first time at the end of 1989 and increased from 2% of the isolates in 1990 to 50% by 1993. A trend for increasing resistance to norfloxacin and ofloxacin was observed during 1985-90 but disappeared in 1991-93. Five isolates with high level resistance to norfloxacin (MIC 2 mg/l) were observed in 1990. Resistance to trimethoprim-sulphamethoxazole (TMP-SMZ) emerged at the end of 1990 and was observed among 10% of the isolates during 1991-3. All strains remained susceptible to ofloxacin, ciprofloxacin, spectinomycin, and ceftriaxone. Overall, 75% of the isolates were prototrophic or required proline for their growth and 62% belonged to serovars IA-6 and IB-1. The prevalence of serovar IB-4 increased strongly during the last 3 years of the study.
Resistance to penicillin, thiamphenicol, and tetracycline was common in N gonorrhoeae during 1985-1993. The rapid spread of TRNG after 1989 and the steep increase of PPNG during 1992-3 were the most striking facts of the study period. The auxotype and serovar distribution was comparable with findings from other African countries.
调查1985 - 1993年期间卢旺达基加利淋病奈瑟菌的体外抗菌药敏性及营养缺陷型/血清型分布情况。
作为监测项目的一部分，采用琼脂稀释法测定了1604株淋病奈瑟菌的体外药敏性。分别对1350株和1313株菌株进行了营养缺陷型和血清型分型。
1985 - 1991年期间，产青霉素酶淋病奈瑟菌（PPNG）的流行率稳定在39%，1992 - 1993年增至61%。非PPNG菌株中对青霉素的染色体耐药很常见，PPNG和非PPNG菌株中对甲砜霉素和四环素的耐药都很常见。1989年底首次观察到高水平、质粒介导的四环素耐药（TRNG），1990年该耐药菌株占分离株的2%，到1993年增至50%。1985 - 1990年期间观察到对诺氟沙星和氧氟沙星耐药性增加的趋势，但在1991 - 1993年消失。1990年观察到5株对诺氟沙星高水平耐药（MIC 2mg/l）的菌株。1990年底出现对甲氧苄啶 - 磺胺甲恶唑（TMP - SMZ）的耐药，1991 - 1993年期间10%的分离株出现该耐药。所有菌株对氧氟沙星、环丙沙星、大观霉素和头孢曲松仍敏感。总体而言，75%的分离株为原养型或生长需要脯氨酸，62%属于血清型IA - 6和IB - 1。在研究的最后3年中，血清型IB - 4的流行率大幅上升。
1985 - 1993年期间，淋病奈瑟菌对青霉素、甲砜霉素和四环素耐药很常见。1989年后TRNG的迅速传播以及1992 - 1993年期间PPNG的急剧增加是研究期间最显著的事实。营养缺陷型和血清型分布与其他非洲国家的研究结果相当。
