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2009–2011年深圳市头孢曲松低敏淋病奈瑟菌的流行特征
作者:张丽君 莫俊銮 王峰 彭毅 赵广录 吕德良
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摘要:

   目的调查2009—2011年深圳市头孢曲松低敏淋病奈瑟菌(淋球菌)流行的基因型和特征。方法收集2009至2011年深圳市淋球菌296株,采用琼脂稀释法筛选出头孢曲松低敏株(最小抑菌浓度为006~050 μg/ml),用logistic回归分析方法,分析与头孢曲松低敏淋球菌感染相关的因素;根据1∶1抽样原则抽取出高敏菌株,与低敏菌株一起进行淋病奈瑟菌抗原序列分析(NGMAST)基因分型和邻接法(neighborjoining, NJ)进化树分析。结果在296株淋球菌中,未发现头孢曲松耐药菌株,头孢曲松低敏菌株53株(179%)。近2个月的抗生素使用史与头孢曲松低敏淋球菌感染相关(OR=3080,95%CI:1376~6894)。53株低敏株的NGMAST共得到48个ST型,由5个成簇的ST(ST1768、ST3927、ST641、ST7076、ST7078各包含了2株淋球菌)和43个单一的ST构成,其中26个ST型中国香港等地曾有报道。NJ进化树未观察到低敏株单独成簇的情况。结论深圳市2009—2011年分离到的296株淋球菌中头孢曲松低敏株的比例较高;深圳市头孢曲松低敏淋球菌菌株的流行可能有其独特的特点。

关键词:奈瑟球菌, 淋病;头孢曲松;分子流行病学

Abstract:

   ObjectiveTo investigate the genotype and characteristics of Neisseria gonorrhoeae (Ngonorrhoeae) isolates with reduced susceptibility to ceftriaxone  in  Shenzhen from 2009 to 2011MethodsA total of 296 Ngonorrhoeae isolates were collected in Shenzhen from 2009 to 2011ceftriaxone strains (minimum inhibitory concentration between 006 and 050 μg/ml) were determined by agar dilution methodLogistic regression was used to analyze the associated factors of ceftriaxone Ngonorrhoeae infectionNeighborjoining(NJ) phylogenetic tree analysis and Ngonorrhoeae multiantigen sequence typing (NGMAST) were performed on all ceftriaxone isolates and susceptible control isolates randomly selected in accordance with the principle of 1∶1 samplingResultsNo isolates displayed resistance to ceftriaxone, whereas 53(179%) showed reduced susceptibility to ceftriaxone among 296 isolatesOnly antibiotic use in recent two months was associated with ceftriaxone isolates infection(OR=3080,95%CI: 1376-6894). Among the ceftriaxone isolates, 48 different ST were identified including 5 STs (ST1768,ST3927,ST641,ST7076 and ST7078) containing 2 isolates and 43 single STsThere were 26 STs previously reported from HongKong in ChinaLow sensitive strains clustering was not observed by NJ phylogenetic treeConclusionThe proportion of ceftriaxone strains among the 296 Ngonorrhoeae isolates collected from 2009 to 2011 in Shenzhen is high The STs of ceftriaxone strains may have  unique epidemic features in Shenzhen

Key words: Neisseria gonorrhoeae;Ceftriaxone;Molecular epidemiology

发表日期:2013/10

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