Antimicrobial Susceptibilities of Neisseria gonorrhoeae in Kigali, Rwanda, and Trends of Resistance Between 1986 and 2000

• Published in: Sexually transmitted diseases 2001-09, Vol.28 (9), p.539-545
• Main Authors: VAN DYCK, EDDY, KARITA, ETIENNE, ABDELLATI, SAID, DIRK, VAN HOVE, NGABONZIZA, MARTIN, LAFORT, YVES, LAGA, MARIE
• Format: Article
• Language: English
• Subjects: Antibacterial agents; Antibiotics. Antiinfectious agents. Antiparasitic agents; Biological and medical sciences; Drug resistance; Drug Resistance, Microbial - genetics; Gonorrhea - drug therapy; Humans; Medical sciences; Microbial Sensitivity Tests - methods; Microorganisms; Neisseria gonorrhoeae - drug effects; Neisseria gonorrhoeae - isolation & purification; Penicillin Resistance; Pharmacology. Drug treatments; Rwanda - epidemiology; Sentinel Surveillance; Sexually transmitted diseases; STD; Trends; Tropical medicine
• ISSN: 0148-5717; 1537-4521
• DOI: 10.1097/00007435-200109000-00012

Background: Plasmid-mediated and chromosomal-mediated resistance of Neisseria gonorrhoeae to penicillin, tetracycline, thiamphenicol, and trimethoprim-sulfamethoxazole has spread dramatically in Africa. Monitoring of antimicrobial susceptibility is a key element in the control of sexually transmitted diseases. Goal: To document antimicrobial susceptibilities of gonococci isolated during the past 15 years in Kigali, Rwanda. Study Design: Minimal inhibitory concentrations of recently collected gonococcal isolates of eight antimicrobials were determined. The results were compared with data collected for isolates obtained since 1986. Results: In 1986, 35% of the gonococcal isolates were penicillinase-producing N gonorrhoeae. Tetracycline-resistant N gonorrhoeae appeared in 1989. The prevalence of penicillinaseproducing N gonorrhoeae and tetracycline-resistant N gonorrhoeae increased significantly to 70.5% and 89.2%, respectively. Chromosomal resistance to penicillin, tetracycline, and thiamphenicol increased temporarily, then decreased significantly. Chromosomal resistance to trimethoprim-sulfamethoxazole appeared in 1988 and increased to 21.6%. All the isolates were susceptible to ceftriaxone, ciprofloxacin, spectinomycin, and kanamycin. Conclusions: This study illustrated the rapidly increasing frequencies of penicillinase-producing N gonorrhoeae and tetracycline-resistant N gonorrhoeae. Chromosomal resistance to thiamphenicol and trimethoprim-sulfamethoxazole excludes these drugs as alternative treatment. Programs for antimicrobial susceptibility surveillance of N gonorrhoeae should urgently be established in Africa.