In Vitro Study On Gentamicin Against Neisseria Gonorrhoeae

Objective:1.To investigate worldwide susceptibility rates of Neisseria gonorrhoeae to genta-micin by analyzing data from all relevant published studies.2.Using the agar dilution method to test the susceptibility of Neisseria gonorrhoeae isolates in our department of dermatology to gentamicin and azithromycin respectively,and to investigate the in vitro synergy testing of gentamicin and azithromycin combinati-on against Neisseria gonorrhoeae by checkerboard dilution method.3.To investigate the in vitro anti-NG characteristics of gentamicin,and to learn about the value of gentamicin in the treatment of gonorrhea.Methods:Searched PubMed,Embase,Web of Science,CNKI,and Wanfang independently to identify studies on susceptibilities of Neisseria gonorrhoeae to gentamicin published from January 1990 to January 2018.The retrieved articles were screened and incorporated into the appropriate literature based on the established criteria.After the data were extracted,analysis was performed using stata14.0 software,meta-analysis was performed using a random effect model,and subgroup analysis was performed.The Begg rank correlation test examines whether there is publication bias in the included literature.Using the agar dilution method to test the susceptibility of Neisseria gonorrhoeae isolates to gentamicin and azithromycinin respectively.Using checkerboard dilution method to investigate the in vitro synergy testing of gentamicin and azithromycin combination against Neisseria gonorrhoeae.Results:After meta analysis,the overall sensitivity detection rate of Neisseria gonorrhoeae to gentamicin was 91.5%?95%CI:85.9%—95.8%?,having heterogeneity between studies?I²=99.0%,P<0.001?.The results using disk diffusion method and Etest method were significantly lower than the results using agar dilution method.Of the Neisseria gonorrhoeae strains collected from our department,92.6%?25/27?were sensitive to azithromycin,7.4%?2/27?were moderately sensitive to azithromycin,and 88.9%?24/27?were sensitive to gentamicin,11.1%?3/27?of the strains were moderately sensitive to gentamicin;no Neisseria gonorrhoeae strains resistant to azithromycin and gentamycin were found.The combination of gentamycin and azithromycin against Neisseria gonorrhoeae mainly showed an additive effect,and synergy and antagonism were not detected.Conclusion:According to meta-analysis results,Neisseria gonorrhoeae stains were sensitive to gentamicin,but the results obtained by different detection methods were be different.In our experiments,it was found that Neisseria gonorrhoeae was highly sensitive to gentamicin and azithromycin.Although no synergistic effect was found,gentamicin in combination with azithromycin is also an alternative to gonorrhoea treatment.The latest American CDC guidelines for the treatment of sexually transmitted diseases recommend gentamicin and azithromycin for the treatment of ceftriaxone-allergic patients with gonorrhea^[1].Therefore,it is necessary to monitor the susceptibility of gonococcus to gentamicin in the surveillance of gonococcal drug resistance.