摘要
目的对淋病奈瑟球菌耐药情况进行监测,同时分析阿奇霉素耐药株基因突变情况。方法选取2021年1月至2023年11月南昌市人民医院与江西中医药大学附属医院检验科检出的138株淋病奈瑟球菌作为研究对象,分析药敏试验结果及目的基因检测结果,观察不同耐药程度阿奇霉素耐药株基因突变情况。结果淋病奈瑟球菌对大观霉素敏感度最高,其次为头孢曲松及阿奇霉素;其对环丙沙星耐药率最高,其次为四环素及青霉素。全部阿奇霉素耐药株均未检出rplV及rplD基因突变,23S核蛋白体RNA(rRNA)出现核苷酸突变菌株占63.64%,a2143g突变菌株占22.73%。mtrR基因启动区碱基a缺失菌株占72.73%,发生H105Y突变菌株占45.45%,发生G45D突变菌株占31.82%。低度耐药株(LLR)菌株检出率达6.52%,中度耐药株(MLR)菌株检出率达5.80%,高度耐药株(HLR)菌株检出率达3.62%。结论淋病奈瑟球菌对大观霉素敏感度最高,对环丙沙星耐药率最高;阿奇霉素耐药株耐药与mtrR、23Sr RNA4个等位基因突变存在关联,临床应根据药敏反应结果合理选择抗菌药物。
Objective To monitor the drug resistance of Neisseria gonorrhoeae and to analyze the mutation of Neisseria gonorrhoeae to azithromycin gene.Methods A total of 138 strains of Neisseria gonorrhoeae detected in the Department of Clinical Laboratory of Nanchang People's Hospital and the Affiliated Hospital of Jiangxi University of TCM from January 2021 to November 2023 were selected as the research objects.The results of drug sensitivity test and target gene detection were analyzed,and the gene mutations of azithromycin resistant strains with different degrees of drug resistance were observed.Results The susceptibility of Neisseria gonorrhoeae to spectinomycin was the highest,followed by ceftriaxone and azithromycin.The resistance rate to ciprofloxacin was the highest,followed by tetracycline and penicillin.No rplV and rplD gene mutations were detected in all azithromyin-resistant strains.63.64%of the strains had 23S ribosomal RNA(rRNA)nucleotide mutations,and 22.73%had a2143g mutations.There were 72.73%strains with base a deletion,45.45%strains with H105Y mutation and 31.82%strains with G45D mutation in mtrR gene promoter region.The detection rates of low drug-resistance strain(LLR),moderate drug-resistance strain(MLR)and high drug-resistance strain(HLR)were 6.52%,5.80%and 3.62%,respectively.Conclusion Neisseria gonorrhoeae has the highest sensitivity to spectinomycin and the highest resistance rate to ciprofloxacin.The resistance of azithromycin strains is associated with the mutations of mtrR and 23Sr RNA alleles,and the antibiotics should be selected rationally according to the results of drug sensitivity.
作者
蒋沁炆
熊文强
李婷
俞凤
李清祥
JIANG Qinwen;XIONG Wenqiang;LI Ting;YU Feng;LI Qingxiang(Department of Clinical Laboratory,Nanchang People's Hospital(the Third Hospital of Nanchang),Jiangxi Province,Nanchang 330009,China;Department of Clinical Laboratory,the Affiliated Hospital of Jiangxi University of TCM,Jiangxi Province,Nanchang 330006,China)
出处
《中国当代医药》
2025年第2期100-103,共4页
China Modern Medicine
基金
江西省卫生健康委科技计划项目(202140075)。
关键词
淋病奈瑟球菌
耐药监测
阿奇霉素
耐药机制
分子流行病学
Neisseria gonorrhoea
Resistance monitoring
Azithromycin
Resistance mechanism
Molecular epidemiology
作者简介
通讯作者:李清祥。
