Auxotypes, serovars, and trends of antimicrobial resistance of Neisseria gonorrhoeae in Kigali, Rwanda (1985-93)

Abstract

Objective: To investigate the in vitro antimicrobial susceptibility and the auxotype/serovar distribution of Neisseria gonorrhoeae in Kigali, Rwanda, during 1985-93. Methods: As part of a monitoring programme the in vitro susceptibility of 1604 isolates of N gonorrhoeae was determined by agar dilution. Auxo-and serotyping was performed on 1350 and 1313 isolates respectively. Results: The prevalence of penicillinase producing N gonorrhoeae (PPNG) remained stable at a rate of 39% during 1985-91 and increased to 61% in 1992-3. Chromosomal resistance to penicillin was common among non-PPNG and resistance to thiamphenicol and tetracycline was common among both PPNG and non-PPNG. High level, plasmid mediated resistance to tetracycline (TRNG) was observed for the first time at the end of 1989 and increased from 2% of the isolates in 1990 to 50% by 1993. A trend for increasing resistance to norfloxacin and ofloxacin was observed during 1985-90 but disappeared in 1991-93. Five isolates with high level resistance to norfloxacin (MIC 2 mg/l) were observed in 1990. Resistance to trimethoprimsulphamethoxazole (TMP-SMZ) emerged at the end of 1990 and was observed among 10% of the isolates during 1991-3. All strains remained susceptible to ofloxacin, ciprofloxacin, spectinomycin, and ceftriaxone. Overall, 75% of the isolates were prototrophic or required proline for their growth and 62% belonged to serovars IA-6 and IB-1. The prevalence of serovar IB-4 increased strongly during the last 3 years of the study. Conclusion: Resistance to penicillin, thiamphenicol, and tetracycline was common in N gonorrhoeae during 1985-1993. The rapid spread of TRNG after 1989 and the steep increase of PPNG during 1992-3 were the most striking facts of the study period. The auxotype and serovar distribution was comparable with findings from other African countries. (Sex Transm Inf 1998;74:205-209)

Five-Year Antimicrobial Susceptibility Trends Among Bacterial Isolates from a Tertiary Health-Care Facility in Kigali, Rwanda

“…[6][7][8][9] Data from the late 1980s and 1990s from Rwanda indicate the presence of multidrug resistance among various pathogens including Streptococcus pneumoniae, Neisseria gonorrhea, Salmonella typhimurium, and Shigella species. [10][11][12][13][14] Subsequent reports by Muvunyi and others in 2011, showed higher rates of AMR than previously reported among uropathogenic Escherichia coli isolates, suggesting increasing trends for AMR. 15 Quite alarming in that study was the observed high rate of resistance of E. coli to commonly used oral antibiotics to treat urinary tract infections, including amoxicillin (89.3%), ciprofloxacin (41.3%), nitrofurantoin (44.9%), and cotrimoxazole (82.7%).…”

Antimicrobial susceptibilities and plasmid patterns of Neisseria gonorrhoeae in Bénin

“…In this study, as well as in all African studies, using recommended methods, all GC isolates were fully susceptible to third generation cephalosporins and to spectinomycin 5,6,8,10,18,19,22,23 . In many African countries, N. gonorrhoeae in vitro susceptibility to thiamphenicol or chloramphenicol has decreased continuously during the last decade 6,11,23,24 . In 2 recent studies no resistance to thiamphenicol/ chloramphenicol was observed 7,19 .…”

“…Our results for kanamycin are in agreement with all African studies using recommended methods and correct in vitro resistance breakpoints 6 with results from studies using non recommended methods which showed resistance prevalences of 17± 23% 25,26 . For TMP± SMZ, African studies using recommended techniques detected resistance levels of 0± 6%, where studies that used non recommended techniques detected resistance levels of 14% to >90% 6,7,19,20,23,26 .…”