2011-2012年海南省淋球菌耐药性监测及基因分型

摘要

目的 探讨海南淋球菌耐药状态及耐药基因分型情况.方法 用琼脂稀释法测定4种抗生素的最低抑菌浓度(MIC),PCR方法鉴定四环素高度耐药菌株(TRNG)并进行TetM基因分型;用纸片酸度法测定β内酰胺酶(PPNG),PCR方法鉴定β内酰胺酶质粒并进行TEM-1基因分型.结果 2011-2012年共检测214株淋球菌,环丙沙星中度敏感率7.94 ％(17/214),耐药率为92.06％(197/214);头孢曲松敏感率24.30％(52/214),中度敏感率为75.70％(162/214);未发现耐大观霉素的菌株.多重耐药情况:对四环素和青霉素耐药的菌株39株(18.22％),对青霉素和环丙沙星耐药菌株66株(30.84％),对四环素和环丙沙星耐药的菌株91株(42.52％),对四环素、青霉素和环丙沙星耐药的菌株37株(17.29％).检出TRNG 101株(47.20％),TetM基因分型结果99株(98.02％)荷兰型,2株(1.98％)美国型.检出PPNG 65株(30.37％),TEM-1基因分型结果55株(84.62％)亚州型,10株(15.38％)非州型,未见多伦多型、里约型.结论 海南省淋球菌对大观霉素敏感率高,应作为治疗淋病的首选药物;多重耐药菌株应引起重视.PPNG以亚州型为主,非州型次之;TRNG以荷兰型为主,偶见美国型.%Objective To evaluate the antibiotic resistance in Neisseria gonorrhoeae (NG) isolates from Hainan province,and to assess their genotypes according to antibiotic resistance-associated genes.Methods Totally,214 NG strains isolated from Hainan province during 2011-2012 were included in this study.An agar dilution method was used to determine the minimum inhibitory concentrations (MICs) of ciprofloxacin,ceftriaxone,spectinomycin and tetracycline in these strains.The production of β-lactamase was tested by a paper acidometric method.PCR was performed to amplify the tetM gene in TRNG strains and TEM-1 gene in penicillinase-producing NG (PPNG) strains for their genotyping.Results Among these NG strains,7.94％ (17/214) were moderately sensitive to ciprofloxacin with a resistance rate of 92.06％ (197/214),24.30％ (52/214) were sensitive to ceftriaxone with a moderate sensitivity rate of 75.70％ (162/214),and none was resistant to spectinomycin.Additionally,39 isolates (18.22％) were concurrently resistant to both tetracycline and penicillin,66 isolates (30.84％) to penicillin and ciprofloxacin,91 isolates (42.52.％) to tetracycline and ciprofloxacin,and 37 isolates (17.29％) to tetracycline,penicillin and ciprofloxacin.Totally,101 TRNG strains were identified from all the isolates,of which,99 (98.02％)harbored the Dutch variant of the tetM gene,and 2 (1.98％) harbored the American variant.There were 65 (31.31％)PPNG strains in these isolates,among which,55 (84.62％) carried the Asian type plasmids,10 (15.38％) carried the Africa type plasmids,and none carried the Toronto or Rio type plasmids.Conclusions The NG isolates from Hainan province is highly sensitive to spectinomycin,which should serve as the first treatment choice for gonorrhea.More attention should be paid to multi-drug resistance in NG.In this region,most PPNG strains carry the Asian type plasmids,followed by the Africa type plasmids,and the Dutch variant of the tetM gene is the most common variant among TRNG strains with the American variant as the occasional form.