Abstract:

Objective To study the current status of antimicrobial resistance of clinical Neisseria gonorrhoeae isolates in China by analyzing the surveillance results in 2008. Methods N. gonorrhoeae strains were collected from 951 eligible patients at national monitoring sites for resistance of N. gonorrheae, including 156 patients from Jiangsu province, 71 from Zhejiang province, 102 from Fujian province, 207 from Guangdong province, 77 from Guangxi province, 43 from Hainan province, 80 from Sichuan province, 44 from Chongqing, 45 from Xinjiang Uygur Autonomous Region, 72 from Shaanxi province, and 54 from Tianjin. The production of β-lactamase was detected by paper acidometric testing, and minimum inhibitory concentrations （MICs） were determined by agar dilution method for spectinomycin, ciprofloxacin, ceftriaxone, tetracycline, respectively. Results Among the 951 N. gonorrhoeae isolates, 2 （0.21%） were resistant to spectinomycin, 451 （47.42%）showed reduced sensitivity to ceftriaxone, 928 （97.58%） were resistant to ciprofloxacin. Penicillinase-producing N. gonorrhoeae （PPNG） and plasmid mediated tetracycline-resistant N. gonorrhoeae （TRNG） accounted for 34.91% （332/951） and 51.21% （487/951） of these isolates respectively. Kendall rank correlation analysis showed that there was a positive correlation between the positivity rate of TRNG and PPNG （r = 0.20, P < 0.01）, but a negative correlation between the susceptibility to ceftriaxone in N. gonorrhoeae and positivity rate of PPNG （r = -0.09, P < 0.01）. No correlation was observed between the susceptibility to ceftriaxone and susceptibility to ciprofloxacin or the positivity rate of TRNG, or between the susceptibility to ciprofloxacin and positivity rate of PPNG or TRNG. Chi-square analysis showed a marked increase in the percentage of N. gonorrhoeae isolates with reduced susceptibility to ceftriaxone in Guangxi province, Hainan province, Xinjiang Uygur Autonomous Region and Shaanxi province, the percentage of N. gonorrhoeae isolates with resisitance to spectinomycin in Shaanxi province, prevelance of TRNG in Guangdong province, and prevelance of PPNG in Sichuan and Zhejiang provinces compared with the average level （all P < 0.05）. Conclusions There is a significant difference in antimicrobial susceptibility of N. gonorrhoeae from different areas of China. A significant elevation is observed in the percentage of N. gonorrhoeae with reduced susceptibility to ceftriaxone and resistance to spectinomycin in Shaanxi province, to which close attention should be paid.

Key words: epidemiology