关键词: 淋病奈瑟菌, 耐药, 流行病学特征

Abstract:

Objective To investigate the characteristic,plasmid type and mechanism of drug resistance of Neisseria gonorrhoeae in Tongji University Shanghai East Hospital South Campus,and to provide a reference for the prevention of Neisseria gonorrhoeae. Methods A total of 142 isolates of Neisseria gonorrhoeae from Tongji University Shanghai East Hospital South Campus were collected from September 2016 to September 2017. Drug susceptibility test in vitro of 7 kinds of common antibiotics was performed by disc diffusion method. The β-lactamase was determined by nitrocephin. The plasmids from all β-lactamase-positive isolates were typed and analyzed for epidemic characteristics. Gene penA of non-sensitive isolates to cephalosporin was amplified and sequenced,which were compared with that of reference isolates for analyzing their drug resistance characteristics. Results The non-susceptibility rates to penicillin,ceftriaxone,cefixime,tetracycline,ciprofloxacin,spectinomycin and azithromycin were 100%,1.4%,17.6%,99.3%,99.3%,0% and 8.5%,respectively. Totally,54（38%） isolates produced β-lactamase,and the plasmid types were Asian plasmid（26 isolates,48%）,African plasmid（27 isolates,50%） and Toronto/Rio plasmid（1 isolate,2%）. Target protein for drug action [penicillin-binding protein 2（PBP2）] in all non-sensitive isolates to cephalosporin were mutated. The mutation points were mainly concentrated in 311-582 amino acid sites. There were 12 isolates with fewer mutation sites（≤10）. There existed A501T/V,A516G,G542S and P551S/T key mutations,and the other 13 isolates had more mutation sites（50-60）,but there was no above key mutation site. Conclusions Ceftriaxone and spectinomycin are the first experience medication for Neisseria gonorrhoeae therapy,azithromycin and cefixime could be candidates,and penicillin,tetracycline and ciprofloxacin have not been suitable for therapy. For β-lactamase resistance,there are mainly Neisseria gonorrhoeae isolates carrying Asian plasmid and African plasmid in Shanghai. The mechanism of Neisseria gonorrhoeae resistance to cephalosporin is complex,and drug action target protein mutagenesis is various.

Key words: Neisseria gonorrhoeae, Drug resistance, Epidemics