Antimicrobial Susceptibilities of Strains of Neisseria gonorrhoeae in Bangkok, Thailand: 1994-1995

• Published in: Sexually transmitted diseases 1997-03, Vol.24 (3), p.142-148
• Main Authors: KNAPP, JOAN S., WONGBA, CHAINARONG, LIMPAKARNJANARAT, KHANCHIT, YOUNG, NANCY L., PAREKH, MANHAR C., NEAL, SANDRA W., BUATIANG, ANUKOOL, CHITWARAKORN, ANUPONG, MASTRO, TIMOTHY D.
• Format: Article
• Language: English
• Subjects: Anti-Bacterial Agents - pharmacology; Anti-Infective Agents - pharmacology; Bacterial diseases; Biological and medical sciences; Drug Resistance, Microbial; Fluoroquinolones; Human bacterial diseases; Infectious diseases; Medical sciences; Microbial Sensitivity Tests; Miscellaneous; Neisseria gonorrhoeae - drug effects; Population; Thailand; Time Factors
• ISSN: 0148-5717; 1537-4521
• DOI: 10.1097/00007435-199703000-00004

Background and Objectives: Failure of uncomplicated gonococcal infections acquired in the Far East to respond to doses of ciprofloxacin and ofloxacin recommended by the Centers for Disease Control and Prevention have been identified in Australia, the United Kingdom, and the United States. In the Republic of the Philippines, 54.3% of strains exhibited decreased susceptibility to fluoroquinolones; 12% of strains were resistant to ciprofloxacin. This study was undertaken to compare the antimicrobial susceptibilities of gonococcal isolates in Bangkok, Thailand, with those in the Republic of the Philippines. Goal: To determine the frequency and diversity of antimicrobial resistance, particularly to fluoroquinolones, in gonococcal strains in Bangkok, Thailand. Study Design: Strains of Neisseria gonorrhoeae isolated from 101 patients with uncomplicated gonorrhea in Bangkok, Thailand, in July, 1994 (46 strains) and November, 1994 to July, 1995 (55 strains), were characterized by auxotype/serovar class, antimicrobial susceptibilities, and plasmid profile. Susceptibilities were determined to penicillin G, tetracycline, ceftriaxone, cefixime, cefoxitin, ciprofloxacin, ofloxacin, norfloxacin, erythromycin, kanamycin, and thiamphenicol. Results: Of 101 strains, 89.1% (90/101) were resistant to penicillin or tetracycline. Plasmid-mediated resistance to penicillin or tetracycline was identified in 33.7% (34/101) of the isolates: penicillinase-producing Neisseria gonorrhoeae (17.8%; 18/101), tetracycline-resistant Neisseria gonorrhoeae (7.9%; 8/101), and penicillinase-producing/tetracycline-resistant Neisseria gonorrhoeae (7.9%; 8/101). Most penicillinase-producing strains (96.2%; 25/26) possessed the 4.4-megadalton (Md) ß-lactamase plasmid; one strain possessed the 3.2-Md ß-lactamase plasmid. Chromosomally mediated resistance to penicillin and tetracycline was exhibited by 51.5% (52/101) of strains, and 4.0% (4/101) were tetracycline resistant. All strains were susceptible to spectinomycin. Of 21.8% (22/101) strains exhibiting decreased susceptibility to ciprofloxacin (minimal inhibitory concentration [MIC] >0.125 µg/ml), one strain (ciprofloxacin MIC, 0.5 µg/ml; ciprofloxacin inhibition zone diameter of 23 mm) had MICs of 2.0 and 8.0 µg/ml for ofloxacin and norfloxacin, respectively, indicating resistance to these agents. Decreased susceptibility to ciprofloxacin was identified in strains with chromosomally mediated resistance to penicillin or tetracycline and in penici