中华皮肤科杂志 ›› 2015, Vol. 48 ›› Issue (5): 312-316.

• 论著 • 上一篇    下一篇

中国部分地区淋球菌耐药监测点产青霉素酶淋球菌及其blaTEM-135突变体的流行调查

陈绍椿1,尹跃平2,戴秀芹3,郑和平4,顾伟鸣5,郑钟洁6,吴兴中7,曹文苓8,胡丽华9,10,朱邦勇11,孙厚华12,陈祥生2   

  1. 1. 中国医学科学院皮肤病研究所，中国疾病预防控制中心性病控制中心
    2. 南京 中国医学科学院北京协和医学院皮肤病研究所
    3. 中国医学科学院皮肤病研究所
    4. 广州市广东省皮肤性病防治中心
    5. 上海市皮肤病医院
    6. 天津市疾病预防控制中心
    7. 广东省皮肤性病防治中心
    8. 广州市皮肤病防治研究所
    9. 浙江省皮肤病防治研究所
    10.
    11. 广西皮肤病防治研究所
    12. 南京医科院皮研所
  • 收稿日期:2014-03-04 修回日期:2014-10-23 出版日期:2015-05-15 发布日期:2015-04-30
  • 通讯作者: 尹跃平 E-mail:yinyp@ncstdlc.org
  • 基金资助:

    国家自然科学基金;协和青年基金暨中央高校基本科研业务费专项资金

Penicillinase-producing Neisseria gonorrhoeae and its blaTEM-135 gene variants at several gonococcal antimicrobial surveillance sites in China: an epidemiological study

  • Received:2014-03-04 Revised:2014-10-23 Online:2015-05-15 Published:2015-04-30

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摘要：

目的 了解中国不同地区淋球菌耐药监测点产青霉素酶淋球菌（PPNG）的比例及blaTEM-135突变体在PPNG中的分布，比较PPNG及blaTEM-135突变体淋球菌多抗原测序分型（NG-MAST）的型别分布，了解不同地区PPNG blaTEM-135突变体的差异与联系。 方法 2012年在江苏、上海、浙江、天津、广东、广西6个淋球菌耐药监测点共收集572株淋球菌，经过分离纯化及鉴定后，采用头孢噻吩纸片法测定PPNG；菌株培养后利用试剂盒提取DNA，通过错配扩增突变分析PCR（MAMA PCR）鉴定blaTEM-135突变体，采用NG-MAST进行分型研究。 结果 572株淋球菌中PPNG总阳性率为38.1%（218/572），PPNG中相应blaTEM-135突变体的总比例为52.3%（114/218）。监测点中PPNG阳性率从高至低分别为：浙江（45/87，51.7%）、上海（36/79，45.6%）、广东（78/205，38.0%）、广西（12/32，37.5%）、江苏（24/77，31.2%）、天津（23/92，25%）；PPNG中相应blaTEM-135突变体的阳性率从高至低分别为：浙江（31/45，68.9%）、江苏（14/24，58.3%）、广东（39/78，50.0%）、上海（17/36，47.2%）、天津（9/23，39.1%）、广西（4/12，33.3%）。NG-MAST分型研究显示，blaTEM-135突变体中流行菌株型别有ST2318、ST1768、ST1866、ST1053、ST8726等，其中ST1768、ST1053和ST8726与blaTEM-135突变体有较强的对应关系。天津PPNG菌株及blaTEM-135突变体ST分布与其他各监测点有显著差异，江浙沪地区菌株ST有一定联系。 结论 中国淋球菌耐药监测点PPNG及相应blaTEM-135突变体阳性率处于较高水平，不同地区间PPNG及相应blaTEM-135突变体阳性菌株ST型别分布差异有统计学意义。

Abstract:

Chen Shaochun*, Yin Yueping, Dai Xiuqin, Zheng Heping, Gu Weiming, Zheng Zhongjie, Wu Xingzhong, Cao Wenling, Hu Lihua, Zhu Bangyong, Sun Houhua, Chen Xiangsheng. *Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College; National Center for Sexually Transmitted Disease Control, China Center for Disease Control and Prevention, Nanjing 210042, China Corresponding author: Yin Yueping, Email: yinyp@ncstdlc.org 【Abstract】 Objective To determine the prevalence of penicillinase-producing Neisseria gonorrhoeae （PPNG） and the distribution of blaTEM-135 gene variants in PPNG at several gonococcal antimicrobial surveillance sites in China, to compare N. gonorrhoeae multi-antigen sequence typing （NG-MAST） types of PPNG and its blaTEM-135 gene variants, and to assess the difference and association in NG-MAST types of blaTEM-135 gene variants among different regions. Methods A total of 572 N. gonorrhoeae isolates were collected at 6 gonococcal antimicrobial surveillance sites from Jiangsu, Shanghai, Zhejiang, Tianjin, Guangdong and Guangxi in 2012. After isolation, purification, and identification, cefalotin paper discs were used for detection of PPNG. DNA was extracted by QIAxtractor DX kits after cultivation of the PPNG strains. Then, mismatch amplification mutation assay （MAMA） PCR was performed to identify blaTEM-135 variants, and NG-MAST analysis to determine N. gonorrhoeae genotypes. Results Among the 572 N. gonorrhoeae strains, 38.1% （218/572） were identified as PPNG, and of the PPNG strains, 52.3% （114/218） were blaTEM-135 variants. The detection rate of PPNG at these surveillance sites from high to low was as follows: 51.7% （45/87, Zhejiang）, 45.6% （36/79, Shanghai）, 38.0% （78/205, Guangdong）, 37.5% （12/32, Guangxi）, 31.2% （24/77, Jiangsu） and 25.0% （23/92, Tianjin）, and that of blaTEM-135 variants was as follows: 68.9% （31/45, Zhejiang）, 58.3% （14/24, Jiangsu）, 50.0% （39/78, Guangdong）, 47.2% （17/36, Shanghai）, 39.1% （9/23, Tianjin） and 33.3% （4/12, Guangxi）. NG-MAST analysis showed that the ST2318, ST1768, ST1866, ST1053 and ST8726 types predominated among these blaTEM-135 variants, and a strong correlation was found between blaTEM-135 variants and some NG-MAST types, such as ST1768, ST1053 and ST8726 types. The distribution of NG-MAST types was significantly different between the surveillance site in Tianjin （in the Northern part of China） and the other sites （in the Southern part of China）, but highly similar among the surveillance sites in Jiangsu, Zhejiang and Shanghai regions. Conclusions There is a high prevalence of PPNG and its blaTEM-135 variants at several gonococcal antimicrobial surveillance sites in China, with significant differences in NG-MAST genotype distribution of PPNG and its blaTEM-135 variants among different regions.