中华皮肤科杂志 ›› 2004, Vol. 37 ›› Issue (6): 323-325.

• 论著 • 上一篇    下一篇

1988-2002年上海分离的淋球菌对抗菌药的敏感性监测

顾伟鸣, 杨阳, 吴磊, 高志琴, 章楚光, 汤全贵, 张皓, 胡伟忠, 程瑛, 王海山   

  1. 上海市皮肤病性病医院 200050
  • 收稿日期:2003-06-30 出版日期:2004-06-15 发布日期:2004-06-15
  • 基金资助:
    上海市卫生局科学基金资助(1424)

Surveillance on Antibiotic Susceptibility of Neisseria Gonorrhoeae from 1988 to 2002 in Shanghai

GU Wei-ming, YANG Yang, WU Lei, GAO Zhi-qin, ZHANG Chu-guang, TANG Quan-gui, ZHANG Hao, HU Wei-zhong, CHENG Ying, WANG Hai-shan   

  1. Shanghai Skin Disease and STD Hospital, Shanghai 200050, China
  • Received:2003-06-30 Online:2004-06-15 Published:2004-06-15

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摘要： 目的 了解上海地区1988-2002年淋球菌对多种抗菌药耐药的发生率、流行情况和耐药特征.方法 采用琼脂稀释法测定抗菌药耐药性,纸片酸度定量法测定青霉素产β-内酰胺酶菌株(PPNG).结果 青霉素敏感性从1988年的11.28%降至2002年的0,MIC50和MIC90分别增加了8倍和4倍,2002年的耐药率达到94.29%,PPNG株达到了50.95%;高度耐四环素株(TRNG)从1995年的0上升到2002年的20.95%;头孢曲松敏感株已由1995年的100%下降至2002年的23.80%;大观霉素的敏感性维持在高点(>97%);环丙沙星敏感性有较大幅度下降,其耐药率在2002年达到了99.05%.分析多重耐药株,同为耐青霉素、环丙沙星和四环素3种药物的菌株从2001年的20.87%上升到2002年的23.30%.同为耐青霉素和环丙沙星2种药物的菌株近2年都已接近70%.结论 近15年来,淋球菌对多种药物产生了耐药,耐药率逐年提高.建议上海地区将大观霉素和头孢曲松作为治疗淋病的首选药物,并且尽早研制出对淋球菌敏感的抗菌药.

关键词: 奈瑟球菌,淋病, 微生物敏感性试验, 青霉素类, 四环素, 头孢曲松, 壮观霉素, 环丙沙星

Abstract: Objective To study the susceptibility of Neisseria gonorrhoeae to antibiotic agents from 1988 to 2002 in Shanghai. Methods The clinical isolates from patients with gonorrhea were collected and tested for their susceptibility to five antibiotics. Agarose-dilution-method was used to detect minimal inhibitory concentration (MIC) of anti-microbial agents including penicillin, tetracycline, spectinomycin, ciprofloxacin and ceftriaxone, and penicillinase producing Neisseria gonorrhoeae (PPNG) were tested with acidometric method. Results Susceptible strains to penicillin decreased from 11.28% in 1988 to 0 in 2002, MIC50 and MIC90 increased 8 and 4 times, respectively, the resistant rate and proportion of PPNG were 94.29% and 50.95%, respectively in 2002. The strains of high resistance to tetracycline increased from 0 in 1995 to 20.95% in 2002. The susceptible strains to ceftriaxone decreased from 100% in 1995 to 23.80% in 2002. The susceptibility to ciprofloxacin decreased significantly and resistant rate reached 99.05% in 2002. However, these strains were kept highly susceptible to spectionmycin. Concerning the multi-drug resistance, we found that the strains resistant to penicillin, ciprofloxacin and tetracycline simultaneously increased from 20.87% in 2001 to 23.30% in 2002, those resistant to both penicillin and ciprofloxacin reached to 70% in the past 2 years. Conclusions In Shanghai the resistant rates of Neisseria gonorrhoeae to antibiotics increased year by year in the past 15 years. The study indicates that spectinomycin and ceftriaxone should be the first choice for the treatment of gonorrhea at present and new sensitive antibiotic should be developed for the treatment of gonorrhea.

Key words: Neisseria gonorrhoeae, Microbial sensitivity tests, Penicillins, Tetracycline, Ceftriaxone, Spectinomycin, Ciprofloxacin