Trends in Neisseria gonorrhoeae Antimicrobial Resistance over a Ten-Year Surveillance Period, Johannesburg, South Africa, 2008⁻2017.
Trends in Neisseria gonorrhoeae Antimicrobial Resistance over a Ten-Year Surveillance Period, Johannesburg, South Africa, 2008⁻2017.
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DOI：
10.3390/antibiotics7030058
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发表时间：
2018-07-12
期刊：
影响因子：
--
通讯作者：
Kufa T
中科院分区：
文献类型：
--
作者：
Kularatne R;Maseko V;Gumede L;Kufa T
背景：在南非，性传播感染（STI）是通过综合征的方法在初级卫生保健中心（PHCs）管理。淋病奈瑟菌是男性尿道炎综合征的主要原因。我们描述了在约翰内斯堡一个大型PHC的10年监测期内淋病奈瑟菌的耐药性模式和趋势。研究方法：淋病奈瑟菌是从2008年至2017年期间在约翰内斯堡亚历山德拉健康中心就诊的同意成年患者的生殖器分泌物拭子标本中培养出来的。通过Etest™（头孢克肟、头孢曲松、环丙沙星）或琼脂稀释（青霉素、四环素、阿奇霉素）测试分离株的抗菌药物敏感性。结果如下：在监测期间，青霉素的高水平耐药率从30%增加到51%（趋势p值< 0.001），四环素从75%增加到83%（趋势p值= 0.008），环丙沙星从25%增加到69%（趋势p值< 0.001）。分析未发现对大观霉素的高水平耐药或对超广谱头孢菌素的最低抑菌浓度（MIC）蠕变，对阿奇霉素的中等耐药率低于5%。结论：诺菌对青霉素、四环素和环丙沙星的耐药率很高。淋病避免了它们在未来的生殖器分泌物的国家治疗算法中的使用。必须继续监测这种快速演变的病原体对目前推荐的抗菌治疗的新出现的耐药性。
Background: In South Africa, sexually transmitted infections (STIs) are managed through a syndromic approach at primary healthcare centres (PHCs). Neisseria gonorrhoeae is the predominant cause of male urethritis syndrome. We describe antimicrobial resistance patterns and trends in Neisseria gonorrhoeae during a ten-year surveillance period at a large PHC in Johannesburg. Methods: Neisseria gonorrhoeae was cultured from genital discharge swab specimens obtained from consenting adult patients presenting at the Alexandra Health Centre in Johannesburg between 2008 and 2017. Isolates were tested for antimicrobial susceptibility by Etest™ (cefixime, ceftriaxone, ciprofloxacin) or agar dilution (penicillin, tetracycline, azithromycin). Results: During the period of surveillance, high-level resistance prevalence increased from 30% to 51% for penicillin (p-value for trend < 0.001), 75% to 83% for tetracycline (p-value for trend = 0.008), and 25% to 69% for ciprofloxacin (p-value for trend < 0.001). Analysis did not reveal high-level resistance to spectinomycin or a minimum inhibitory concentration (MIC) creep for extended-spectrum cephalosporins, and the prevalence of intermediate-resistance to azithromycin was less than 5%. Conclusions: High prevalence resistance to penicillin, tetracycline, and ciprofloxacin in N. gonorrhoeae obviates their use in future national treatment algorithms for genital discharge. It is essential to continue monitoring for emerging resistance to currently recommended antimicrobial therapy in this rapidly evolving pathogen.
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