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Результаты мониторинга антибактериальной резистентности N. Gonorrhoeae в г. Могилеве за 2017–2019 г.

А. В. Анискевич, И. Г. Шиманская, Т. Н. Голубовская, И. Н. Станиславова, А. П. Адаскевич, М. Унемо УО «Белорусский государственный медицинский университет», Могилевский областной кожно-венерологический диспансер, Университетский Госпиталь Эребру, Швеция
2022 №1 | Лекции
Аннотация
Список литературы
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В статье представлены результаты клинического исследования, проведенного в 2018 и 2020 г. с целью определения показателей антибиотикорезистентности штаммов N. Gonorrhoeae в Республике Беларусь. В исследование включено 114 культур N. gonorrhoeae из г. Могилев. Из них 36 изолятов культивировано в 2017 г., 19 изолятов – в 2018 и 59 изолятов – в 2019 г. Все образцы получены из цервикального канала у женщин либо уретры у мужчин с установленным диагнозом «гонорея». Мужчины – 82 (72 %), женщины – 32 (28 %). Средний (медиана) возраст составлял 26 (23,5) лет для мужчин (диапазон: 17–44 года) и 27 (23,5) лет для женщин (диапазон: 17–74 года). Определялась чувствительность N. gonorrhoeae к цефтриаксону, цефиксиму, азитромицину, ципрофлоксацину, спектиномицину, бензилпенициллину, тетрациклину и гентамицину с использованием Е-теста (количественный метод определения минимальной ингибирующей концентрации антимикробного препарата, действующей против микроорганизма). Для всех изолятов был использован html5-dom-document-internal-entity2-946-end-лактамазный тест. С учетом полученных данных даны рекомендации по использованию отдельных антимикробных препаратов при лечении гонореи.
Ключевые слова:
гонорея, антимикробные препараты, штаммы N.gonorrhoeae, антибиотикорезистентность, лечение
The results of monitoring the antibacterial resistance of N. Gonorrhoeae in the Mogilev city for 2017–2019

The article presents the results of a clinical study conducted in 2018 and 2020 to determine the antibiotic resistance indicators for N. gonorrhoea strains in Belarus. One hundred and fourteen (114) cultures of N. gonorrhoeae from Mogilev were included in the works: thirty six (36) cultures were isolated from patients in 2017, nineteen (19) in 2018 and fifty nine (59) in 2019. All samples were obtained from the cervical canal in women or the urethra in men, with an established diagnosis of gonorrhea. Men concluded 82 persons equal to 72 %, and women 32 equal 28 %. The average age of men was 23.5 (range: 17–44 years), women 23,5 (range: 17–74 years). The susceptibility to ceftriaxone, cefixime, azithromycin, ciprofloxacin, spectinomycin, benzylpenicillin, tetracycline and gentamicin were determined using the Etest for determination of the minimum inhibitory concentrations. Recommendations on the use of certain antimicrobial agents in the treatment of gonorrhea is based on data obtained.

Keywords
gonorrhea, antimicrobial agents, strains of N. gonorrhoeae, antibiotic resistance, medication
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  • References
  • 1. Newman, L., Rowley J., Vander Hoorn S., Wijesooriya N. S., Unemo M., Low N., Stevens G., Gottlieb S., Kiarie J., Temmerman M. Global estimates of the prevalence and incidence of four curable sexually transmitted infections in 2012 based on systematic review and global reporting // PLoSOne. – 2015. – Vol. 10(12). doi: 10.1371/journal.pone. 0143304
  • 2. WHO. Report on global sexually transmitted infection surveillance. – Geneva: World Health Organization, 2018. Available at: http://recipe.by/wp-content/uploads/2019/10/Metodicheskie-ukazaniya.pdf
  • 3. Unemo, M., Seifert H. S., Hook III E. W., Hawkes S., Ndowa F., Jo-Anne R. Dillon J.-A. R. Gonorrhoea. Nature Reviews Disease Primers. – 2019. – Vol. 5, № 79. – P. 1–27. Available at: https://www.nature.com/articles/s41572-019-0128-6
  • 4. Zdravookhraneniye v Respublike Belarus’: ofits. stat. sb. za 2017 g. [Public Health in the Republic of Belarus:An official statistics collection, 2017]. – Minsk: RNMB, 2018. – 274 p. Available at: http://minzdrav.gov.by/upload/dadvfiles/Zdravoohranenie%20RB%20sbornik_2017.pdf (in Russian)
  • 5. Zinovsky, V. I. et al. Zdorov’e naselenija Respubliki Belarus’ 2009–2014: stat. sb. [Health of the population of the Republic of Belarus 2009–2014: statistical collection]. – Minsk, 2014. – 57 p. (in Russian)
  • 6. Rubin, D. H. F., Ross J. D. C., Grad Y. H. The frontiers of addressing antibiotic resistance in Neisseria gonorrhea. Translational Research. – 2020. doi: 10.1016/j.trsl.2020.02.002
  • 7. Bignell, C., Unemo M. 2012 European guideline on the diagnosis and treatment of gonorrhoea in adults // International Journal of STD & AIDS. – 2013. – Vol. 24(2). – P. 85–92. doi:10.1177/0956462412472837
  • 8. World Health Organization. Global action plan to control the spread and impact of antimicrobial resistance in Neisseria gonorrhea. – 2012. – 36 p. Available at: https://apps.who.int/iris/bitstream/handle/10665/44863/9789241503501_eng.pdf?sequence = 1
  • 9. Prikaz, M. Z. RB ot 20.05.2009 № 485 «Ob utverzhdenii instruktsii po laboratornoy diagnostike gonorei». Available at: http://gokvd.grodno.by/files/doc/MZRB-Prikaz-2009-05-20-485.pdf (in Russian)
  • 10. EUCAST. Review and revision of antimicrobial breakpoints: EUCAST SOP 3.2, 23 January 2018. Available at: http://www.eucast.org /fileadmin/src/media/PDFs/EUCAST_files/EUCAST_SOPs/2018/EUCAST_SOP_3.2_Breakpoint_Review_and_Revision_20180123.pdf (Accessed July 2, 2019).
  • 11. Kersh, E. N., Allen V., Ransom E., Schmerer M., St. Cyr S., Workowski K., Weinstock H., Patel J., Ferraro M. J. Rationale for a Neisseria gonorrhea Susceptible Only Interpretive Breakpoint for Azithromycin // Clin. Infect. Dis. – 2020. – Vol. 70, № 5. – P. 798–804. doi: 10.1093/cid/ciz292
  • 12. Chen, M. Y., Stevens K., Tideman R., Zaia A.,Tomita T., Fairley C. K., Lahra M., Whiley D., Hogg G. Failure of 500 mg of ceftriaxone to eradicate pharyngeal gonorrhoea, Australia // Journal of Antimicrobial Chemotherapy. – 2013. – Vol. 68, № 6. – P. 1445–1447. doi: 10.1093/jac/dkt017
  • 13. Lebedzeu, L., Golparian D., Titov L., Pankratava N., Glazkova S., Shimanskaya I., Charniakova N., Lukyanau A., Domeika M., Unemo M. Antimicrobial susceptibility/resistance and NG-MAST characterisation of in Belarus, Eastern Europe, 2010–2013 // BMC Infectious Diseases. – 2015. – Vol. 15(1). – 29 p. doi: 10.1186/s12879-015-0755-9
  • 14. Glazkova, S., Golparian D., Titov L., Pankratova N., Suhabokava N., Shimanskaya I., Domeika M., Unemo M. Antimicrobial susceptibility⁄resistance and molecular epidemiological characteristics of Neisseria gonorrhea in 2009 in Belarus // Apmis. – 2011. – Vol. 119. – P. 537–42.doi: 10.1111/j.1600-0463.2011.02770.x
  • 15. WHO. Surveillance standards for antimicrobial resistance. WHO/CDS/ CSR/DRS/2001.5. – Geneva, 2001. –
  • 16 p. Available at: https://www.who.int/csr/resources/publications/drugresist/whocdscsrdrs20015.pdf
  • Поступила 17.06.2021 г.