Analysis Of Drug Sensitivity Of N. Gonorrhoeae And Study On Relationship Between Azithromycin Susceptibility And Drug Resistance Genes MtrR, RplD And RplV In Taiyuan, Shanxi

Objective:1.To analysis of the sensitivity of gonococci to cephalosporins,penicillin,tetracycline,spectinomycin,macrolides(azithromycin),fluoroquinolone(ciprofloxacin)antibiotics in patients with urethral secretions in patients with Taiyuan gonorrhea in Shanxi2.Analyze the relationship between azithromycin sensitivity changes and drug resistance genes mtrR,rplD and rplV mutations in Taiyuan,Shanxi.Method:1.Collect the specimens of urethral secretions of suspected gonorrhea patients in the Second Hospital of Shanxi Medical University from October 2018 to December 2019,and culture and identify them as Gonorrhea.The sensitivity of gonococci to cephalosporins,penicillin,tetracycline,spectinomycin,macrolide(azithromycin),fluoroquinolone(ciprofloxacin)antibiotics was tested by agar dilution method.2.Select azithromycin low-sensitivity and drug-resistant strains of gonococcus(MIC?0.5mg/L)and its sensitive strains(MIC?0.25mg/L),extract DNA,and amplify mtrR,rplV and rplD gene fragments,and compare and analyze the existence Changes in genes and amino acids.Result:1.The resistance rates of Neisseria gonorrhoeae to cephalosporins,azithromycin,spectinomycin,ciprofloxacin,and penicillin are 0,10.0%,98.0%,10.0%,100%,100%.Among them,9 strains were hyposensitive and 5 strains were resistant.2.(1)14 resistant and low-sensitive strains were found mtrR gene amplification,5 strains G45 D and H105 Y amino acid substitutions,2 strains A39 T mutations,and no deletion ofA at position 33 of mtrR promoter.(2)No mutations in rplD and rplV genes were found in14 azithromycin-resistant and low-sensitivity strains.Conclusion:1.Azithromycin,tetracycline,spectinomycin,ciprofloxacin and penicillin are not suitable for the treatment of Neisseria gonorrhoeae in Taiyuan Shanxi,while ceftriaxone and cefixime are still suitable for the treatment of Neisseria gonorrhoeae in Taiyuan,Shanxi.Azithromycin has a high drug resistance rate,and its sensitivity needs to be continuously monitored.2.Among 14 azithromycin hyposensitivity and resistant strains(1)G45D and H105 Y amino acid substitutions are related to gonococcal azithromycin resistance;(2)RplD and rplV gene mutations and gonococcal drug sensitivity to azithromycin are uncertain.Continuous monitoring of antibiotic resistance monitoring can better grasp the local epidemiological situation and provide a theoretical basis for clinical diagnosis and treatment.