Antimicrobial resistance of Neisseria gonorrhoeae isolated from patients attending sexually transmitted infection clinics in Urban Hospitals, Lusaka, Zambia.
Antimicrobial resistance of Neisseria gonorrhoeae isolated from patients attending sexually transmitted infection clinics in Urban Hospitals, Lusaka, Zambia.
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DOI：
10.1186/s12879-022-07674-y
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发表时间：
2022-08-12
影响因子：
3.7
通讯作者：
Kwenda, Geoffrey
中科院分区：
文献类型：
--
作者：
Sarenje, Kelvin L.;Ngalamika, Owen;Maimbolwa, Margaret C.;Siame, Amon;Munsaka, Sody M.;Kwenda, Geoffrey
淋病奈瑟菌是性传播感染（STI）淋病的病原体，它的出现对获得可用于治疗的抗菌药物的耐药性产生了重大的公共卫生影响。N.淋病限制了治疗选择，并导致淋病相关的高发病率。耐药性（AMR）的资料，在N。淋病在赞比亚令人恐惧。本研究旨在测定N.来自赞比亚卢萨卡的淋病分离物。对2019年至2020年期间出现尿道或阴道分泌物的630例STI患者进行了前瞻性横断面研究。尿道和宫颈分泌物在改良Thayer Martin琼脂上培养，并在36 °C ± 1 °C、5% CO2下孵育24 h。鉴定N.通过革兰氏染色、氧化酶、头孢硝肟纸片、BactiCard奈瑟菌和Viteck® Compact获得淋病分离株。使用E-检验确定AMR特征。通过Pearson卡方检验、Mann-Whitney U检验或逻辑回归确定统计学显著性，p值< 0.05表示显著性。共招募了630例患者，其中46%（290/630）为男性，中位年龄为29岁，四分位距（IQR）为19-39岁。女性的中位数为26岁，IQR为15-37岁。淋病奈瑟菌从19.4%（122/630）的患者中分离出来，其中72.9%（89/122）为男性，25-34岁年龄组的分离率最高。对青霉素、四环素和环丙沙星的耐药率分别为85.2%、68.9%和59.8%，MIC 90分别为32 μg/mL、8 μg/mL和8 μg/mL。对头孢克肟、大观霉素和阿奇霉素的敏感率分别为1.6%、4.9%和4.9%。所有分离株均对头孢曲松敏感。与AMR相关的风险因素是女性的冲洗（AOR 6.69，95% CI; 1.11-40.31，p = 0.039），女性（AOR 7.64，95% CI; 1.11-52.33，p = 0.048），HIV阳性（AOR 26.59，95% CI; 3.67-192.7，p = 0.005），未使用避孕套或无保护性行为（AOR 5.48，95% CI; 1.17-22.75 p = 0.026）、性交易（AOR 4.19，95% CI; 1.55-11.33，p = 0.010）和非处方环丙沙星治疗（AOR 3.44，95% CI; 1.17-22.75，p = 0.023）。了N.淋病对青霉素、四环素和环丙沙星的耐药性很高，需要修订治疗指南。但未检测到头孢曲松耐药。因此，监测抗生素耐药性在赞比亚仍然至关重要。在线版本包含补充材料，可通过10.1186/s12879-022-07674-y获得。
Neisseria gonorrhoeae, the causative agent for sexually transmitted infection (STI) gonorrhoea, has emerged with a significant public health impact on acquiring resistance to antimicrobials available for treatment. The resistance of N. gonorrhoeae limit treatment options and contributed to high morbidity associated with gonorrhoea. Data on antimicrobial resistance (AMR) profiles in N. gonorrhoeae is scares in Zambia. This study aimed to determine the antibiotic susceptibilities in N. gonorrhoeae isolates from Lusaka, Zambia. A prospective cross-sectional study was conducted on 630 STI patients who presented with urethral or vaginal discharge from 2019 to 2020. Urethral and endocervical secretions were cultured on Modified Thayer Martin agar and incubated at 36 °C ± 1 °C in 5% CO2 for 24 h. Identification of N. gonorrhoeae isolates was achieved by Gram stain, oxidase, nitrocefin disk, BactiCard Neisseria, and Viteck® Compact. The AMR profiles were determined using E-test. Statistical significant was determined by Pearson’s Chi-square test, Mann-Whitney U test, or logistic regression with p-values of < 0.05 indicating significance. A total of 630 patients were recruited of which 46% (290/630) with the median of 29 years and interquartile range (IQR) of 19–39 years were male. The median of the females was 26 years and IQR of 15–37 years. Neisseria gonorrhoeae was isolated from 19.4% (122/630) patients of which 72.9% (89/122) were male, with highest prevalence of isolation in the age category of 25–34 years. The prevalence of resistance was high to penicillin (85.2%), tetracycline (68.9%) and ciprofloxacin (59.8%) with MIC90 of 32 µg/mL, 8 µg/mL, and 8 µg/mL respectively. The isolates had reduced susceptibility to cefixime (1.6%), spectinomycin (4.9%) and (4.9%) for azithromycin. All isolates were susceptible to ceftriaxone. Risk factors associated with AMR were douching in females (AOR 6.69, 95% CI; 1.11–40.31, p = 0.039), female gender (AOR 7.64, 95% CI; 1.11–52.33, p = 0.048), HIV-positivity (AOR 26.59, 95% CI; 3.67–192.7, p = 0.005), no condom use or unprotected sex (AOR 5.48, 95% CI; 1.17–22.75 p = 0.026), sex trading (AOR 4.19, 95% CI; 1.55–11.33, p = 0.010), and over-counter treatment of ciprofloxacin (AOR 3.44, 95% CI; 1.17–22.75, p = 0.023). The N. gonorrhoeae resistance to penicillin, tetracycline and ciprofloxacin was high necessitating revision of the treatment guidelines. However, no resistance to ceftriaxone was detected. Therefore, monitoring of antibiotic resistance remains critical in Zambia. The online version contains supplementary material available at 10.1186/s12879-022-07674-y.
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DOI：
10.1016/s2352-4642(20)30335-7
发表时间：
2021-03
期刊：
The Lancet. Child & adolescent health
影响因子：
--
作者：
Martin K;Olaru ID;Buwu N;Bandason T;Marks M;Dauya E;Muzangwa J;Mabey D;Dziva Chikwari C;Francis SC;Tembo M;Mavodza C;Simms V;Mackworth-Young CRS;Machiha A;Kranzer K;Ferrand RA
通讯作者：
Ferrand RA
影响因子：
3.6
作者：
Liu, Bette;Roberts, Christine L.;Ward, James
通讯作者：
Ward, James
影响因子：
2.5
作者：
Hamoonga, Twaambo Euphemia;Olowski, Pawel;Musonda, Patrick
通讯作者：
Musonda, Patrick
影响因子：
15.8
作者：
Alirol E;Wi TE;Bala M;Bazzo ML;Chen XS;Deal C;Dillon JR;Kularatne R;Heim J;Hooft van Huijsduijnen R;Hook EW;Lahra MM;Lewis DA;Ndowa F;Shafer WM;Tayler L;Workowski K;Unemo M;Balasegaram M
通讯作者：
Balasegaram M
影响因子：
1.7
作者：
Lowe, Sara;Mudzviti, Tinashe;Pascoe, Margaret
通讯作者：
Pascoe, Margaret