2013～2017年嘉兴地区淋病奈瑟菌的耐药性分析
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摘要
目的了解2013～2017年嘉兴地区淋病奈瑟菌对常见抗菌药物的耐药情况,以指导临床合理用药。方法回顾性搜集并分析嘉兴市第一医院2013～2017年分离的490株淋病奈瑟菌耐药情况。结果 2013～2017年淋病奈瑟菌的年分离率呈上升趋势,差异有统计学意义(χ~2=48.30,P<0.05)。2013～2017年淋病奈瑟菌对青霉素、头孢西丁、大观霉素的耐药率差异无统计学意义(χ~2分别=2.43、3.20、6.78,P均>0.05);对四环素、环丙沙星的耐药率有明显差异(χ~2分别=10.71、9.92,P均<0.05);对头孢他啶、头孢噻肟的敏感性均为100%,未发现耐药菌株。5年内淋病奈瑟菌β-内酰胺酶的阳性率差异无统计学意义(χ~2=0.98,P>0.05),平均为34.90%。结论淋病奈瑟菌对青霉素、四环素、环丙沙星的耐药性相当高,已不再适用于淋病的治疗,而对头孢他啶、头孢噻肟、头孢西丁、大观霉素较敏感,可作为治疗淋病的选择药物。
Objective To understand the resistance of Neisseria gonorrhoeae to common antibiotics in Jiaxing area from 2013 to 2017 so as to guide rational drug usage in clinic. Methods Retrospectively collected and analyzed the drug resistance of 490 strains of Neisseria gonorrhoeae isolated from the first hospital of Jiaxing from 2013 to 2017.Results The annual segregation rate of Neisseria gonorrhoeae showed an upward trend from 2013 to 2017,and the difference was statistically significant(χ~2=48.30,P<0.05).There was no significant difference in the resistance rates of Neisseria gonorrhoeae to penicillin,cefoxitin and spectinomycin from 2013 to 2017(χ~2=2.43,3.20,6.78,P>0.05).The resistance rates of Neisseria gonorrhoeae to tetracycline and ciprofloxacin were significantly different(χ~2=10.71,9.92,P<0.05).The sensitivities of Neisseria gonorrhoeae to ceftazidime and cefotaxime were all 100%,and no resistant strain was found.There was no significant difference in the positive rate of Neisseria gonorrhoeae β-lactamase within 5 years(χ~2=0.98,P>0.05),the average positive rate was 34.90%. Conclusion The resistances of Neisseria gonorrhoeae to penicillin,tetracycline and ciprofloxacin are quite high and they are no longer suitable for the treatment of gonorrhea.It is sensitive to ceftazidime,cefotaxime,cefoxitin,and spectinomycin,which can be used as a drug the treatment of gonorrhea.
Objective To understand the resistance of Neisseria gonorrhoeae to common antibiotics in Jiaxing area from 2013 to 2017 so as to guide rational drug usage in clinic. Methods Retrospectively collected and analyzed the drug resistance of 490 strains of Neisseria gonorrhoeae isolated from the first hospital of Jiaxing from 2013 to 2017.Results The annual segregation rate of Neisseria gonorrhoeae showed an upward trend from 2013 to 2017,and the difference was statistically significant(χ~2=48.30,P<0.05).There was no significant difference in the resistance rates of Neisseria gonorrhoeae to penicillin,cefoxitin and spectinomycin from 2013 to 2017(χ~2=2.43,3.20,6.78,P>0.05).The resistance rates of Neisseria gonorrhoeae to tetracycline and ciprofloxacin were significantly different(χ~2=10.71,9.92,P<0.05).The sensitivities of Neisseria gonorrhoeae to ceftazidime and cefotaxime were all 100%,and no resistant strain was found.There was no significant difference in the positive rate of Neisseria gonorrhoeae β-lactamase within 5 years(χ~2=0.98,P>0.05),the average positive rate was 34.90%. Conclusion The resistances of Neisseria gonorrhoeae to penicillin,tetracycline and ciprofloxacin are quite high and they are no longer suitable for the treatment of gonorrhea.It is sensitive to ceftazidime,cefotaxime,cefoxitin,and spectinomycin,which can be used as a drug the treatment of gonorrhea.
引文
1吴志华.现代性病学[M].北京:人民卫生出版社,2015.152.
2 赵钊,王巧刚,沈雅婕,等.浙江省702株淋病奈瑟菌的耐药性分析[J].中国现代医生,2018,17(6):115-117.
3 谢大泽,湛学军,陶雪花,等.南昌地区淋球菌对抗生素的耐药性及质粒谱分析[J].检验医学与临床,2010,7(23):2605-2606.
4 陈霄霄,张芳,赵恬,等.淋球菌耐药性的研究进展[J].中国中西医结合皮肤性病学杂志,2015,14(1):62-65.
5 Tapsall JW. Surveillance of antibiotic resistance in Neisseria gonorrhoeae in the WHO western pacific re?gion,1998.The WHO estern pacific gonococcal antimi?crobial sureillance programe[J]. Commun Dis Intell Q Rep,2000,24(1):1-4.
6 蒋英,刘建,谢延,等.103株淋球菌耐药性研究[J].实用预防医学,2013,20(3):345-347.
7 李治请,刘宏星,谢江铃.武鸣县182例淋球菌药敏检测结果分析[J].应用预防医学,2016,22(2):155-158.
8 Araneta C,Juayang A.Antibiotic susceptibility of neisse?ria gonorrhoeae in Bacolod city,Philippines[J].Trop Med Infect Dis,2017,2(3):45.
2 赵钊,王巧刚,沈雅婕,等.浙江省702株淋病奈瑟菌的耐药性分析[J].中国现代医生,2018,17(6):115-117.
3 谢大泽,湛学军,陶雪花,等.南昌地区淋球菌对抗生素的耐药性及质粒谱分析[J].检验医学与临床,2010,7(23):2605-2606.
4 陈霄霄,张芳,赵恬,等.淋球菌耐药性的研究进展[J].中国中西医结合皮肤性病学杂志,2015,14(1):62-65.
5 Tapsall JW. Surveillance of antibiotic resistance in Neisseria gonorrhoeae in the WHO western pacific re?gion,1998.The WHO estern pacific gonococcal antimi?crobial sureillance programe[J]. Commun Dis Intell Q Rep,2000,24(1):1-4.
6 蒋英,刘建,谢延,等.103株淋球菌耐药性研究[J].实用预防医学,2013,20(3):345-347.
7 李治请,刘宏星,谢江铃.武鸣县182例淋球菌药敏检测结果分析[J].应用预防医学,2016,22(2):155-158.
8 Araneta C,Juayang A.Antibiotic susceptibility of neisse?ria gonorrhoeae in Bacolod city,Philippines[J].Trop Med Infect Dis,2017,2(3):45.