Analysis of trends in antimicrobial resistance in Neisseria gonorrhoeae isolated in Australia, 1997 2006.
Analysis of trends in antimicrobial resistance in Neisseria gonorrhoeae isolated in Australia, 1997 2006.
复制标题
1997 年和 2006 年澳大利亚分离的淋病奈瑟菌抗菌药物耐药性趋势分析。
DOI：
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发表时间：
2007
影响因子：
5.2
通讯作者：
D. Murphy
中科院分区：
文献类型：
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作者：
J. Tapsall;Edna A. Limnios;D. Murphy
目标
分析1997年至2006年期间在澳大利亚分离的淋病奈瑟菌（GC）的抗菌素耐药性（AMR）趋势，并确定影响GC中AMR出现和传播的因素。
方法
AMR数据是在澳大利亚每个州和地区的参考实验室中使用澳大利亚淋球菌监测计划的方法从GC的综合样本中生成的。对青霉素、环丙沙星、壮观霉素和头孢曲松耐药或高度四环素耐药菌株的比例趋势是根据国家汇总数据确定的，并按区域分列。还对其他AMR、人口统计学、传播和抗生素使用数据进行了进一步分析。
结果
检查了36，000多个GC。在国家数据和城市人群中，对青霉素和环丙沙星以及TRNG的耐药性显著增加。到2006年，在较大的城市中心检测的GC中约有一半对青霉素和/或环丙沙星具有耐药性。这些高耐药率的出现，尽管低（青霉素）或不存在（环丙沙星）暴露。相比之下，在农村和偏远地区，疾病率非常高，青霉素使用率高，<5%的GC测试是青霉素（或喹诺酮）耐药。未检出耐壮观霉素的GC。从2001年起，每年在城市中心，头孢曲松MIC升高的GC数量较少。
结论
在截至2006年的10年中，澳大利亚部分地区GC的AMR显著增加。数据表明，在城市人群中GC中观察到的AMR是其重复输入澳大利亚并最终引入已建立的性网络的结果，而不是从头开始或由于抗生素使用或滥用的选择。
OBJECTIVES
To analyse trends in antimicrobial resistance (AMR) in Neisseria gonorrhoeae (GC) isolated in Australia between 1997 and 2006 and to identify factors influencing emergence and spread of AMR in GC.
METHODS
AMR data were generated in reference laboratories in each state and territory of Australia using the methods of the Australian Gonococcal Surveillance Programme from a comprehensive sample of GC. Trends in the proportion of strains resistant to penicillin, ciprofloxacin, spectinomycin and ceftriaxone or with high-level tetracycline resistance (TRNG) were determined from aggregated national data and were also disaggregated by region. Further analyses of additional AMR, demographic, transmission and antibiotic use data were also performed.
RESULTS
More than 36,000 GC were examined. Significant increases in resistance to penicillin and ciprofloxacin and in TRNG occurred in national data and in urban populations. Approximately half of the GC tested in larger urban centres were penicillin and/or ciprofloxacin resistant by 2006. These high rates of resistance arose despite low (penicillin) or absent (ciprofloxacin) exposure. In contrast, in rural and remote areas with very high disease rates and high rates of penicillin use, <5% of GC tested were penicillin (or quinolone) resistant. No spectinomycin-resistant GC were detected. Low numbers of GC with raised MICs of ceftriaxone were present in urban centres each year from 2001 onwards.
CONCLUSIONS
Significant increases in AMR in GC occurred in parts of Australia in the 10 years to 2006. The data suggest that the AMR seen in GC in urban populations were the result of their repeated importation into Australia and ultimate introduction into established sexual networks rather than originating de novo or as a result of selection by antibiotic use or misuse.