Antibiotic susceptibility survey of Neisseria gonorrhoeae in Thailand

Antibiotic susceptibilities were determined for 122 Neisseria gonorrheae isolates obtained from 400 sex workers in Jakarta, Indonesia, and susceptibilities to ciprofloxacin, cefuroxime, cefoxitin, cefotaxime, ceftriaxone, chloramphenicol, and spectinomycin were found. All isolates were resistant to tetracycline. A number of the isolates demonstrated decreased susceptibilities to erythromycin (MIC > 1.0 g/ml), thiamphenicol (MIC > 1.0 g/ml), kanamycin (MIC > 16.0 g/ml), penicillin (MIC > 2.0 g/ml), gentamicin (MIC > 16.0 g/ml), and norfloxacin (MIC ‫؍‬ 0.5 g/ml). These data showed that certain antibiotics previously used in the treatment of gonorrhea are no longer effective.

supporting

confidence: 83%

In Vitro Antibiotic Susceptibility of Neisseria gonorrhoeae in Jakarta, Indonesia

Lesmana

Lebron

Taslim³

et al. 2001

“…The failure of an infection to respond to enoxacin was reported in 1987 (23). Recently, strains of N. gonorrhoeae exhibiting decreased susceptibilities to ciprofloxacin and ofloxacin have also been reported from Asia (4,17), the United Kingdom (9,11), North America (13,14), and Spain (1). The failure of infections caused by strains for which the MICs were 0.5, 1.0, and 16.0 g of ciprofloxacin per ml to respond to doses of at least 500 mg of ciprofloxacin have been documented in Australia and the United Kingdom (1,5,20).…”

mentioning

confidence: 99%

Proposed criteria for interpretation of susceptibilities of strains of Neisseria gonorrhoeae to ciprofloxacin, ofloxacin, enoxacin, lomefloxacin, and norfloxacin

Knapp

Hale

Neal

et al. 1995

The susceptibilities of 45 strains of Neisseria gonorrhoeae, including 25 strains susceptible to ciprofloxacin (MICs, <0.06 g/ml) and 20 strains exhibiting decreased susceptibilities to ciprofloxacin (MICs, >0.125 g/ml), to ciprofloxacin, ofloxacin, enoxacin, lomefloxacin, norfloxacin, and nalidixic acid were determined by agar dilution and disk diffusion. On the basis of theoretical calculations of predicted susceptibilities at which infections may fail therapy (supported by observed failures of infections to respond to the therapeutic doses of enoxacin and ciprofloxacin), the Centers for Disease Control and Prevention has adopted the following agar dilution breakpoints for interpretation of resistance to these agents: MICs of >1.0 g of ciprofloxacin, enoxacin, and norfloxacin per ml and MICs of >2.0 g of ofloxacin and lomefloxacin per ml. The corresponding disk diffusion breakpoints for these agents were as follows: ciprofloxacin, <29 mm; ofloxacin, <24 mm; enoxacin, <31 mm; lomefloxacin, <26 mm; and norfloxacin,

“…More recently, however, the incidence of gonorrhea has been increasing and was up to 13 reported cases per 100,000 population in 2001 (10). The documentation of a case of gonococcal urethritis with clinical and laboratory failure of ciprofloxacin therapy (9) prompted a study of the antimicrobial susceptibilities of N. gonorrhoeae isolates in the Tel Aviv area of Israel.Gonococcal strains with reduced in vitro susceptibilities to fluoroquinolones (MIC of ciprofloxacin, 0.125 to 0.5 g/ml) were first described in the mid-1980s (5) and since then have been identified in the Far East (7,8,20), Australia (21, 22), Africa (3), Europe (12,13,23), and the United States (4). Fluoroquinolone-resistant N. gonorrhoeae (ciprofloxacin MICs, Ն1 g/ml) emerged during the early 1990s and became well established in several Asian countries (16).…”

mentioning

confidence: 99%

“…Gonococcal strains with reduced in vitro susceptibilities to fluoroquinolones (MIC of ciprofloxacin, 0.125 to 0.5 g/ml) were first described in the mid-1980s (5) and since then have been identified in the Far East (7,8,20), Australia (21,22), Africa (3), Europe (12,13,23), and the United States (4). Fluoroquinolone-resistant N. gonorrhoeae (ciprofloxacin MICs, Ն1 g/ml) emerged during the early 1990s and became well established in several Asian countries (16).…”

mentioning

confidence: 99%

High Prevalence of High-Level Ciprofloxacin Resistance in Neisseria gonorrhoeae in Tel Aviv, Israel: Correlation with Response to Therapy

Dan

Poch

Sheinberg

2002

A survey of the drug susceptibilities of gonococcal isolates from 100 consecutive patients attending clinics in the Tel Aviv area of Israel during the period from February to September 2000 has shown a 61% rate of ciprofloxacin resistance (MICs, >1 g/ml); 51 isolates were highly resistant (MICs, >4 g/ml). Ciprofloxacinresistant strains were more prevalent among isolates with chromosomally mediated resistance to penicillin and tetracycline. Therapeutic failures with ciprofloxacin correlated with MICs of >1 mg/ml (P < 0.01). The high rate of ciprofloxacin resistance coinciding with a sharp rise in the incidence of gonorrhea precludes the use of fluoroquinolone drugs for the empirical treatment of gonococcal infections acquired in Israel.Gonorrhea was rarely reported in Israel in the 1990s, with an average annual incidence of 0.9 cases per 100,000 population (14). As most laboratories did not carry appropriate media, diagnosis was usually made on the basis of Gram-stained smears, and susceptibility testing of Neisseria gonorrhoeae was not routinely performed. More recently, however, the incidence of gonorrhea has been increasing and was up to 13 reported cases per 100,000 population in 2001 (10). The documentation of a case of gonococcal urethritis with clinical and laboratory failure of ciprofloxacin therapy (9) prompted a study of the antimicrobial susceptibilities of N. gonorrhoeae isolates in the Tel Aviv area of Israel.Gonococcal strains with reduced in vitro susceptibilities to fluoroquinolones (MIC of ciprofloxacin, 0.125 to 0.5 g/ml) were first described in the mid-1980s (5) and since then have been identified in the Far East (7,8,20), Australia (21, 22), Africa (3), Europe (12,13,23), and the United States (4). Fluoroquinolone-resistant N. gonorrhoeae (ciprofloxacin MICs, Ն1 g/ml) emerged during the early 1990s and became well established in several Asian countries (16). Strains for which ciprofloxacin MICs were Ն8 g/ml were first isolated in 1994 (15) and have mostly been detected in the Far East (1, 24). Two cases of gonorrhea caused by strains for which the MIC was 16 g/ml were recently reported in the United States (5). These changes in the susceptibility patterns of N. gonorrhoeae may lead to the reassessment of the current recommendations for empirical therapy of gonococcal infection (6). Continuous surveillance of the epidemiology of N. gonorrhoeae based on type characterization and detailed in vitro testing of the antimicrobial susceptibilities of isolates are imperative for establishing empirical treatment guidelines. MATERIALS AND METHODSSource of isolates. N. gonorrhoeae strains were isolated from clinical specimens (mostly urethral discharges from male patients) at the Central Laboratory of Maccabi Health Services, Rishon-le-Zion, Israel. The Central Laboratory serves a population of 400,000 in the Tel Aviv area, situated in central Israel. All isolates recovered from February 2000 and on were transferred to the Infectious Diseases Research Laboratory at the E. Wolfson Hospital, Holon, Israel. ...