广州地区74株淋球菌耐药性结果分析

目的了解广州地区淋球菌对抗生素的耐药性及PPNG和TRNG的流行状况。方法用琼脂稀释法测定最低抑菌浓度（MIC）;用纸片碘量法检测β-内酰胺酶。结果74株淋球菌检出PPNG31株（41．9％）、TRNG19株（25．7％）、环丙沙星耐药率达97．3％,高度耐药株（MIC≥16mg／L）22株（29．7％）,未发现对头孢三嗪、壮观霉素耐药的菌株,且抗菌活性最强。结论持续监测淋球菌的耐药性十分重要。     

2003年广州地区淋球菌对抗生素耐药性结果分析

目的了解广州地区淋球菌对抗生素的耐药性及PPNG和TRNG的流行状况.方法用琼脂稀释法测定最低抑菌浓度(MIC)以及用纸片碘量法检测β-内酰胺酶.结果 116株淋球菌检出PPNG30株(25.9%)、TRNG36株(31%)、环丙沙星耐药率达93.1%,头孢三嗪、壮观霉素未发现耐药菌株,且抗菌活性最强.结论持续监测淋球菌的耐药性十分重要.     

1998～2002年广州地区淋球菌对抗生素耐药性的变迁

目的 :了解 1998～ 2 0 0 2年广州地区淋球菌对 5种抗生素的耐药性的变迁及产青霉素酶淋球菌(PPNG)和高水平耐四环素淋球菌 (TRNG)的流行状况。方法 :用琼脂稀释法测定最低抑菌浓度 (MIC)以及用纸片碘量法检测β-内酰胺酶。结果 :60 3株淋球菌检出 PPNG 64株 (10 .6% )、TRNG 83株 (13 .7% ) ,1998～ 2 0 0 2年 ,PPNG、TRNG流行率及环丙沙星耐药率 ,经μ检验 ,P<0 .0 1,差异有显著性。头孢曲松、壮观霉素未发现耐药菌株 ,壮观霉素抗菌活性最强。结论 :持续监测淋球菌的耐药性十分重要     

广州地区淋球菌抗生素耐药性及质粒图谱研究

目的：了解广州地区淋球菌对抗生素的耐药性及质粒图谱。方法：用琼脂稀释法测定5种抗生素对167株菌的最低抑菌浓度（MIC）及用破裂解法分析160株菌的质粒图谱。结果：167株淋球菌检出PPN9株（5．4％）,TRNG16株（9．6％）,环丙沙星耐药率达78．4％,头孢三嗪,壮观霉素未发现耐药菌株。160株菌其质粒谱型2．6Md 4.5Md(24.4%),2.6Md 4.5Md 24.5Md(20.6%),2.6Md 24.5Md(20.6%),4.5Md检出率（45％）24.5Md检出率（41．3％）。结论：表明了广州地区淋球菌抗生素的耐药性和质粒图谱,有助于淋病的治疗和防治。     

126株淋病奈瑟菌耐药性分析及其所致感染的中西医结合治疗

目的研究近几年来淋病奈瑟菌(简称淋球菌)对抗生素的敏感性,探讨中西医结合治疗的有效性。方法对我科从2000年1月～2007年6月收治保存的126株淋球菌分别用纸片扩散法和快速药敏测试法进行15种药物的药敏检测,并用头孢曲松合并中药治疗。结果用快速定量药敏检测法测定的最小抑菌浓度(MIC)与用K-B法基本相符。对环丙沙星的耐药率为40%,1.50%的菌株耐大观霉素(MIC≥64μg/ml);所有菌株均对头孢曲松敏感。中西医结合治疗所有病例均获得痊愈。结论头孢曲松药物敏感性无明显变化,6年间未发现耐药菌株;环丙沙星耐药性显著上升。中西医结合在淋病治疗中有效可行。     

淋球菌耐药性与耐药质粒的研究

为了解湛江地区淋球菌耐药现状及耐药质粒的分布,并初步探讨其相互关系,对１９９８￣１９９９年广东省湛江地区健康鉴定出的９８株淋球菌流行株,应用纸片扩散法测定细胞对１０种抗生素的敏感性,并采用碱裂解法进行质粒抽提,分析耐药质粒的分布情况,选取ＮＧ４、ＮＧ３１、ＮＧ４３、ＮＧ７０进行细菌的接合试验,以观察耐药质粒能否通过接合进行传递以及传递后受体菌耐药性的变化。结果显示６．１２％菌株对全部抗生素敏感,４８．９６％的菌株对３种及３种以上的抗生素耐药;共检出四种不同分子量的质闰,７．４ｋｂ和４．２ｋｂ质粒检出率较高,分别为５９．１６％和６７．３２％,质粒谱型１２种,以７．４ｋｇ＋４．２ｋｇ和３９．５ｋｇ＋７．４ｋｇ＋４．２ｋｇ为主,占３８．７６％。在细菌的接合传递试验中,ＮＧ４３可通过接合传递将其耐药性传递给淋球菌及大肠     

仙居县儿童下呼吸道感染肺炎克雷伯菌耐药性分析

目的分析仙居人民医院住院下呼吸道感染患儿临床分离肺炎克雷伯菌的耐药特征,为临床合理用药提供依据。方法选择2012年7月至2013年7月该院下呼吸道感染肺炎克雷伯菌阳性患儿81例。对患儿的临床一般资料进行分析,对临床分离菌株进行细菌鉴定,用18种抗生素进行药敏试验,采用WHONET5．4分析软件进行统计。结果2012年7月至2013年7月共分离出81株肺炎克雷伯菌,ESBLs阳性42株,检出率为51．85％。所有菌株对亚胺培南、厄他培南、左旋氧氟沙星、丁胺卡那100％敏感。对氨苄西林耐药率为100％。ESBLs阴性菌株对氨曲南、头孢曲松、头孢他啶、头孢唑啉、头孢吡肟100％敏感,而ESBLs阳性菌株则100％耐药。ESBLs阴性菌株对其他抗生素的耐药率为氨苄西彬舒巴坦（12．82％）、环丙沙星（2．56％）、头孢替坦（O％）、呋喃妥因（20．51％）、庆大霉素（5．13％）、复方新诺明（17．85％）、妥布霉素（2．56％）、哌拉西林／他唑巴坦（2．56％）;ESBLs阳性菌株对其他抗生素的耐药率为氨苄西林／舒巴坦（73．80％）、环丙沙星（2．38％）、头孢替坦（16．67％）、呋喃妥因（61．90％）、庆大霉素（28．57％）、复方新诺明（54．76％）、妥布霉素（7．14％）、哌拉西林／他唑巴坦（7．14％）。结论本地区患儿中肺炎克雷伯菌耐药性较高,临床应重视病原菌的检测。     

不同时期分离的淋病奈瑟菌对5种抗生素的敏感性研究

目的：研究杭州市不同时期分离的林病奈瑟菌对5种抗生素的敏感性。方法：用琼脂烯释法对门诊1998年7月～2001年10月分离的285株淋病奈瑟菌进行青霉素、四环素、壮观霉素、氧氟沙星及头孢曲松的最小抑菌浓度（MIC）测定,并就PPNG株和non-PPNG株菌的MIC值进行了比较。结果：青霉素、四环毒等5种抗生素MIC值2001年～1998年两者之间比较,青霉素、四环素等5种抗生素MIC值2001年与1998年两者之间比较,除壮观霉素没有变化外,其余都有显著变化,而氧氟沙星变化最大,PP-NG菌株与非PPNG株菌MIC值除氧氟沙星外均存在差异。结论：表明了杭州市淋病奈瑟菌5种抗生素耐药性变迁,以便为临床选择用药提供依据。     

郴州地区淋病奈瑟菌耐药性特点分析

目的 了解郴州市区域内病奈瑟菌耐药性特点,为临床用药提供依据。方法 收集郴州市区域内12家医院门诊病人泌尿生殖道分泌物中分离的255株淋球菌,并作为药敏试验,分析其特点。结果 255株淋球菌对青霉素100％耐药,对复方新诺明、氨苄、青霉素、四环素等耐药严重,同时耐毒霉素、头孢三嗪、环丙沙星等交叉耐药现象严重。结论 临床上治疗淋病须以体外药敏试验为依据用药,以提高疗效和减少耐药菌株的产生。     

开封市鼓楼区健康人群大肠埃希菌耐药性调查

目的对开封市鼓楼区从业人员开展大肠埃希菌耐药性调查。方法对2300名健康从业人员分离到2010株大肠埃希菌用14种抗生素进行药敏试验。结果75．0％以上菌株对青霉素、氨苄西林、氯林克霉素和红霉素耐药,80％以上对先锋V、头孢三嗪、头孢哌酮敏感。71．0％菌株呈多重耐药性,耐药谱以青霉素类、大环内酯类、氨基糖苷类为主。结论导致大肠埃希菌高耐药性的原因是：（1）本地区抗生素使用造成的选择性压力;（2）抗生素的滥用;（3）不良卫生习惯。     

Antibiotic resistant N. gonorrhoeae in Trinidad and Tobago.

We tested the susceptibility patterns of 128 N. gonorrhoeae isolates to six antimicrobials; penicillin, tetracycline, spectinomycin, ceftriaxone, ciprofloxacin and azithromycin, and examined whether certain demographic or behavioral factors related to antibiotic use increased the likelihood of infection by a resistant strain. There was a low rate of resistance to penicillin; penicillinase-producing and chromosomal-mediated penicillin resistant gonorrhea were estimated to be 0.8%. A much higher proportion of isolates were resistant to tetracycline (up to 15%). All isolates were sensitive to spectinomycin, ciprofloxacin and ceftriaxone. However, less than 2% of isolates displayed intermediate resistance to both ciprofloxacin and ceftriaxone, and 9% exhibited intermediate resistance to spectinomycin. Patients who had obtained medication before attending the clinic and had taken all of the medication were more likely (p = 0.03) to be infected with a resistant strain of gonococcus. Also, patients who were asked by a clinic doctor to return for a test of cure during an earlier clinic visit, but who did not return were more likely to be infected with a resistant organism (p = 0.006) compared to those who returned at the doctor's request. These findings have important implications for antibiotic use and educational programs in Trinidad and Tobago.     

The antimicrobial susceptibility of Escherichia coli isolated in eastern area of Romania. A surveillance study

To evaluate the resistance trends for Escherichia coli isolates during 1993-1999 period in Eastern Romania to: ampicillin (A), ampicillin-sulbactam (A/S), ceftazidime (CAZ), cefotaxime (CTA), ceftriaxone (CRO), aztreonam (AZT), ofloxacin (OF), ciprofloxacin (CIP), tetracycline (T) and chloramphenicol (C). We tested 2012 clinical isolates obtained from faeces and urine. MICs were determined by a dilution method in Mueller-Hinton agar (NCCLS guidelines). Resistance rates were analyzed using the NCCLS breakpoints for the fully susceptible category (moderately susceptible strains were classified as resistant). No significant differences were observed in susceptibility of E. coli to ampicillin and ampicillin/sulbactam in the last years. The high percentage of resistant isolates was observed in 1995 for ampicillin (89.7%). Higher incidences of resistance were detected for A, A/S, T; the addition of sulbactam restored A susceptibility only for a small percent. CAZ, CTA, CRO, AZT, OF and CIP resistance among E. coli isolates was progressively increased in the last period.     

Trends in antibiotic resistance in Prevotella species from patients of the University Hospital of Maxillofacial Surgery,Sofia, Bulgaria,in 2003–2009

Head-and-neck infections often involve anaerobes such as Prevotella species. Aim of the present study was to assess the evolution and the factors associated with resistance in Prevotella species to penicillin, clindamycin, metronidazole, tetracycline and β-lactams/β-lactamase inhibitors (BL/BLIs). In total, 192 Prevotella strains, isolated from patients with oral and head-and-neck infections, were evaluated. Common isolates were Prevotella intermedia and Prevotella melaninogenica within the pigmented species as well as Prevotella oris and Prevotella oralis group within the non-pigmented species. Overall resistance was 43.2% for penicillin, 10.9% for clindamycin, 0% for metronidazole. Nonsusceptibility to tetracycline was 29.1% without significant differences in resistance rates between pigmented and other species. Penicillin resistant strains were β-lactamase positive. From 2003–2004 to 2007–2009, penicillin resistance rates increased about four-fold (from 15.4% to 60.6%). Clindamycin resistance did not show evolution, whereas tetracycline nonsusceptibility decreased from 43.3% in 2003–2004 to 20.7% in 2007–2009. Except for one (0.5%) P. oralis strain with intermediate susceptibility to BL/BLIs, the other strains were susceptible to the agents. In conclusion, in Prevotella strains from patients with head-and-neck infections, the resistance rate to penicillin increased, that to clindamycin remained stable and the nonsusceptibility rate to tetracycline decreased during the period. Activity against >99% of Prevotella strains was observed with metronidazole and BL/BLIs. The penicillin resistance and tetracycline nonsusceptibility were associated with the year of study, national antibiotic consumption and possibly with previous treatment (for tetracycline). The evolution of penicillin resistance in Prevotella strains was highly dynamic.     

Antimicrobial resistance markers as a monitoring index of gonorrhoea in Thailand

Multiplex PCR was applied to explore the antimicrobial-resistance profiles of 145 gonococci isolated from Bangrak Hospital, Thailand in 2007. All isolates were clearly identified for the plasmid-mediated resistant types of penicillin (Asia, Africa and Toronto) and tetracycline (American and Dutch). This method can also predict the decreased susceptibility to ciprofloxacin by detection of Ser-91 mutation. Prevalence rates of penicillinase-producing Neisseria gonorrhoeae (PPNG) and high-level tetracycline-resistance N. gonorrhoeae (TRNG) were shown to be high as 82.1% and 84.1%, respectively. Most PPNG carried the Africa-type (78.2%) while the American-type (61.8%) was harboured in most TRNG. Mono- and triple-resistance patterns were presented in 2.6% and 79.5% of male, 20.7% and 62.1% of men who have sex with men (MSM), 0% and 75.0% of female, and 10% and 70% of female sex workers (FSW). Additionally, the rate of the Dutch type was high in patients among the age of 35-44 years (57.1%) and female patients (43.8%). The changing types of plasmids have been noticed during the time period of study. The multi-resistance patterns of the gonococcal isolates can be used as an epidemiological index of gonorrhoea and human sexual behaviours. This information will support the management of individual patients as well as the public health surveillance.     

Plasmid-encoded multidrug resistance: A case study of Salmonella and Shigella from enteric diarrhea sources among humans

Salmonellosis and shigellosis are significant and persistent causes of diarrheal diseases among humans in developing countries. With that in mind, the current study investigates the occurrence of plasmid-encoded multidrug resistances in Salmonella and Shigella from diarrheal cases among humans. The isolates were characterized by serotyping, antimicrobial-susceptibility testing, transfer experiments and curing. The extended spectrum β-lactamase (ESBL) was detected by the double disc diffusion synergy test (DDST). A significant number of the plasmid-encoded multidrug resistant (PEMDR) Salmonella and Shigella isolates were found to harbour transferable plasmid genes resistant to antibiotics like ampicillin, chloramphenicol, trimethoprim-sulfamethoxazole, ceftriaxone, cefuroxime and to a lesser extent to ciprofloxacin and ofloxacin. The conjugative R-plasmids-encoded extended-spectrum β-lactamase also showed resistances to cephalosporins (ceftriaxone and cefuroxime) and ampicillin. Curing experiments showed chromosomal resistances to varied antibiotics. The findings confirmed the presence of PEMDR in Salmonella and Shigella strains as a suitable adaptation to a changing antibiotic environment. The results therefore suggest the limited use of the commonly prescribed/or third generation cephalosporins as an empirical treatment of multidrug resistant Salmonella and Shigella because this may affect therapeutic outcomes.     

儿童肺炎链球菌和流感嗜血杆菌耐药及感染特征分析

目的 了解儿童呼吸道感染肺炎链球菌(Streptococcus pneumonia,SP)和流感嗜血杆菌(Haemophilus influenzae,Hi)的分布特征、耐药情况,及耐药菌抗生素间的相互影响,以更合理地指导临床用药.方法 对2009-2010年临床呼吸道感染患儿进行痰、咽拭子或肺泡灌洗液培养分离Hi和SP.因子需求试验鉴定Hi,头孢硝噻酚法检测β-内酰胺酶;奥普托辛和胆汁溶菌试验确认SP.两菌均采用K-B法检测常用对抗生素的耐药性.结果 收集SP 495株,Hi 515株,多见于3岁以下儿童,以呼吸科分离率最高.SP对红霉素、四环素、阿奇霉素、复方新诺明的耐药率分别为98.4％、66.1％、98％和81.6％,其对青霉素敏感性仅为9.5％.Hi有42.7％产生β-内酰胺酶,Hi对氯霉素、复方新诺明、氨苄青霉素、阿奇霉素的耐药率分别为22.1％、21.6％、36.7％和62.7％.与青霉素敏感SP和β-内酰胺酶阴性Hi相比,耐药SP和阳性Hi更易对氯霉素、四环素和复方新诺明耐药.结论 SP和Hi以婴幼儿为主,多见于呼吸科.其耐药情况严峻,青霉素耐药和产β-内酰胺酶菌株会诱导其他抗生素耐药,引发多重耐药.合理使用抗生素以及对两菌的耐药监测应引起高度重视.     

Antimicrobial resistance patterns of Campylobacter from feedlot cattle*

AIMS: This study examined 448 Campylobacter strains isolated in 1999 and 2000 from US feedlot cattle for resistance to 12 antimicrobials. METHODS AND RESULTS: Isolates were tested for antimicrobial susceptibility using the E-test method. Approximately 60% (n = 267) were resistant to one or more antimicrobials, and 19.6% (n = 88) were resistant to two or more antimicrobials. Of the Campylobacter jejuni isolates, 49.1% (n = 187) were resistant to tetracycline, 10.2% (n = 39) were resistant to nalidixic acid, 8.4% were resistant to trimethoprim/sulfamethoxazole, and 1.8% (n = 7) were resistant to ciprofloxacin. Resistance to any of the other eight antimicrobials was 1.3% or less, but 14.4% (n = 55) were resistant to two or more antimicrobials. In the Campylobacter coli group, 65.7% (n = 44) were resistant to tetracycline, 52.2% (n = 35) were resistant to trimethoprim/sulfamethoxazole, 22.4% (n = 15) were resistant to nalidixic acid, and 9.0% (n = 6) were resistant to ciprofloxacin. Resistance to any of the remaining eight antimicrobials was 3.0% or less, although 49.3% (n = 33) were resistant to two or more antimicrobials. CONCLUSIONS: Although antimicrobials are widely used in US feedlot cattle production, our results demonstrate generally low levels of resistance to a broad range of commonly used antimicrobials relative to other recent studies. SIGNIFICANCE AND IMPACT OF THE STUDY: Resistance data on Campylobacter isolated from this major US livestock commodity is lacking. This overview enhances current knowledge and provides a basis for further studies.     

Susceptibility, phenotypes of resistance, and extended-spectrum β-lactamases in Acinetobacter baumannii strains

Acinetobacter baumannii plays an increasing role in the pathogenesis of infections in humans. The bacilli are frequently isolated from patients treated in intensive care units. A growing resistance to antibiotics is leading to the emergence of strains that are multidrug-resistant and resistant to all available agents. The objective of this study was to assess susceptibility to antibiotics and to determine the presence and current level of the extended-spectrum β-lactamases (ESBLs) and attempt to isolate the Acinetobacter baumannii strain carrying the blaPER gene. A total of 51 strains of A. baumannii identified by phenotypic features were examined. That the strains belonged to the species was confirmed by the presence of the blaOXA-51-like; gene. A broth microdilution method was used for antibacterial susceptibility testing. The occurrence of ESBLs was determined using phenotypic double-disk synergy tests. The PCR technique was used to confirm the presence of the blaPER-1; gene encoding ESBL. The most active antibiotics were meropenem, cefepime and ampicillin/sulbactam, with susceptibility shown by 76.5%, 60.8% and 56.9% of the strains, respectively. The strains exhibited the highest resistance (> 75%) to piperacillin, tetracycline, ciprofloxacin and cefotaxime. Phenotypic tests revealed ESBL mechanism of resistance in approximately 20% of Acinetobacter baumannii isolates. However, the PCR technique did not confirm the presence of the blaPER-1; gene in any of the Acinetobacter baumannii strains examined in our hospital. Acinetobacter baumannii strains demonstrate considerable resistance to many groups of antibiotics. Our findings indicate the involvement of enzymes belonging to families other than PER β-lactamase in resistance to β-lactams in A. baumannii.     

Characterization of multiple-antimicrobial-resistant salmonella serovars isolated from retail meats

A total of 133 Salmonella isolates recovered from retail meats purchased in the United States and the People's Republic of China were assayed for antimicrobial susceptibility, the presence of integrons and antimicrobial resistance genes, and horizontal transfer of characterized antimicrobial resistance determinants via conjugation. Seventy-three (82%) of these Salmonella isolates were resistant to at least one antimicrobial agent. Resistance to the following antibiotics was common among the United States isolates: tetracycline (68% of the isolates were resistant), streptomycin (61%), sulfamethoxazole (42%), and ampicillin (29%). Eight Salmonella isolates (6%) were resistant to ceftriaxone. Fourteen isolates (11%) from the People's Republic of China were resistant to nalidixic acid and displayed decreased susceptibility to ciprofloxacin. A total of 19 different antimicrobial resistance genes were identified in 30 multidrug-resistant Salmonella isolates. The bla(CMY-2) gene, encoding a class A AmpC beta-lactamase, was detected in all 10 Salmonella isolates resistant to extended-spectrum beta-lactams. Resistance to ampicillin was most often associated with a TEM-1 family beta-lactamase gene. Six aminoglycoside resistance genes, aadA1, aadA2, aacC2, Kn, aph(3)-IIa, and aac(3)-IVa, were commonly present in the Salmonella isolates. Sixteen (54%) of 30 Salmonella isolates tested had integrons ranging in size from 0.75 to 2.7 kb. Conjugation studies demonstrated that there was plasmid-mediated transfer of genes encoding CMY-2 and TEM-1-like beta-lactamases. These data indicate that Salmonella isolates recovered from retail raw meats are commonly resistant to multiple antimicrobials, including those used for treating salmonellosis, such as ceftriaxone. Genes conferring antimicrobial resistance in Salmonella are often carried on integrons and plasmids and could be transmitted through conjugation. These mobile DNA elements have likely played an important role in transmission and dissemination of antimicrobial resistance determinants among Salmonella strains.