Chromosomally Mediated Resistance in Neisseria gonorrhoeae in the United States: Results of Surveillance and Reporting, 1983-1984

Rice, Roselyn J.; Biddle, James W.; Jeanlouis, Y; DeWitt, Wallis E.; Blount, Joseph H.; Morse, Stephen

doi:10.1093/infdis/153.2.340

Cited by 63 publications

(27 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Decreased susceptibility to the expanded-spectrum cephalosporins such as cefoxitin and cefuroxime has also developed (12,18). In the present study, chromosomally mediated resistance to penicillin G and tetracycline and decreased susceptibility to cefoxitin were highly correlated with increased MICs of ceftriaxone.…”

Section: Discussionsupporting

confidence: 56%

“…Previous work by others has suggested an association between protein I serovar and chromosomally mediated resistance to antibiotics (18,24). The pattern of serovar-auxotypes found in a community is not stable from year to year (17,21), and clonal outbreaks of particular strains may occur (10).…”

Section: Discussionmentioning

confidence: 99%

“…Clinically significant chromosomal resistance to levels of penicillin G or tetracycline, attainable with single doses of penicillin G or with maximum dosages of tetracycline, has been recognized in the gonococcus since the early 1980s (6,18), and the genetic loci involved in resistance to these antibiotics are closely related (5,7,12). Decreased susceptibility to the expanded-spectrum cephalosporins such as cefoxitin and cefuroxime has also developed (12,18).…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Trends in susceptibility of Neisseria gonorrhoeae to ceftriaxone from 1985 through 1991

Schwebke

Whittington

Rice

et al. 1995

Antimicrob Agents Chemother

View full text Add to dashboard Cite

The antimicrobial susceptibilities of 16,441 gonococcal isolates from Seattle-King County were determined for ceftriaxone, cefoxitin, penicillin G, and tetracycline. From 1985 to 1989, ceftriaxone, in combination with doxycycline, was increasingly used for treatment of gonorrhea, and by 1989, it was used as therapy for >80% of cases in Seattle-King County. MICs of ceftriaxone correlated significantly (P < 0.001) with those of the other beta-lactam antibiotics included in this study. Geometric mean MICs of penicillin G for isolates that did not produce ␤-lactamase increased from 1985 to 1991. The geometric mean MICs of cefoxitin, ceftriaxone, and tetracycline began to decline in 1987 but increased in 1990 and 1991. The percentage of strains with decreased susceptibility to ceftriaxone (MIC, 0.06 to 0.25 g/ml) rose from 0.3% in 1985 to 5.3% in 1987 but subsequently declined steadily to 2.6% in 1991, despite increased use of ceftriaxone as routine therapy for gonorrhea. Changes in patterns of antimicrobial susceptibility may be related not only to antimicrobial selection pressures but also to less well understood population shifts among Neisseria gonorrhoeae strains within a community.Neisseria gonorrhoeae has consistently developed resistance to the antimicrobial agents used for the treatment of gonorrhea (23). An excellent example of the effects of antibiotic selection pressure occurred in Korea, where penicillin resistance prompted primary therapy with spectinomycin, only to be followed by development of resistance to this antibiotic (1).In 1989, the Centers for Disease Control (Atlanta, Ga.) recommended ceftriaxone given as a single intramuscular dose of 250 mg as primary therapy for gonorrhea (3). Although a 125-mg dose of ceftriaxone had proven effective in clinical trials (8, 15), it was not widely recommended because of concern regarding the development of resistance to this antimicrobial agent with the use of the smaller dose (3). However, the Seattle-King County Department of Public Health Sexually Transmitted Diseases (STD) Clinic at Harborview Medical Center employed ceftriaxone in a dose of 125 mg given intramuscularly, followed by doxycycline, 100 mg twice daily by mouth for 7 days, since 1985. By mid-1987, this regimen became the standard therapy for gonorrhea in the STD clinic. By 1989, over 80% of the gonorrhea cases in both public clinics and the private sector in Seattle-King County were treated with ceftriaxone and doxycycline, and this remained the most commonly used therapy for gonorrhea through 1991.A laboratory surveillance system for gonococcal antimicrobial susceptibility was implemented in Seattle-King County in late 1985, since which time Ͼ80% of gonococcal isolates from reported cases have been referred to the Neisseria Reference Laboratory for antimicrobial susceptibility testing. This surveillance system permitted the assessment of the relationship of widespread ceftriaxone therapy for gonorrhea to trends in susceptibility of N. gonorrhoeae to ceftriaxone and other antibiotics. MATERI...

show abstract

Section: Discussionsupporting

confidence: 56%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Trends in susceptibility of Neisseria gonorrhoeae to ceftriaxone from 1985 through 1991

Schwebke

Whittington

Rice

et al. 1995

Antimicrob Agents Chemother

View full text Add to dashboard Cite

show abstract

“…Among the men, 91 strains were cultured from the urethra, 5 from the urethra and pharynx, 1 from the pharynx, and 3 from the rectum. Among the women, 11 strains were cultured from the cervix alone, 12 from the cervix and the rectum, 4 from the rectum alone, and 2 from the cervix and pharynx. When multiple sites were infected or colonized in the same patient, the MICs for all the strains were determined.…”

Section: Resultsmentioning

confidence: 99%

Susceptibility to cephalosporins of penicillin-susceptible and penicillin-resistant strains of Neisseria gonorrhoeae from Philadelphia

Fekete

Serfass

Lafredo

et al. 1989

Antimicrob Agents Chemother

View full text Add to dashboard Cite

Using agar dilution, we determined MICs of penicillin, cefoxitin, ceftriaxone, cefmetazole, tetracycline, and spectinomycin for 129 strains of Neisseria gonorrhoeae. All strains were susceptible to ceftriaxone (MIC range, .0.008 to 0.06 ,ug/ml) and spectinomycin (16 to 32 ,ug/ml). The MICs for 50, 90, and 100% of strains tested were 1.0, 2.0, and >8.0 ,ug/ml; 0.12, 1.0, and >8.0 ,Ig/ml; 0.5, 1.0, and 2.0 ,ug/ml; and 1.0, 2.0, and >8.0 ,ug/ml for cefmetazole, penicillin, cefoxitin, and tetracycline, respectively. Seven strains were Il-lactamase producers; eight were chromosomally resistant to penicillin. There was a log-linear relation for non-P-lactamase-producing strains between the MICs of cefmetazole, cefoxitin, and tetracycline and the MIC of penicillin (Pearson r = 0.787, 0.544, and 0.358, respectively).The treatment strategy for presumed or microbiologically documented gonorrheal infection has changed in the light of new information regarding the susceptibility of Neisseria gonorrhoeae to penicillin and tetracycline (6). Most laboratories do not test each strain for antimicrobial susceptibilities; thus clinicians rely on epidemiologic data from regional or national authorities to guide therapy. Cephalosporins such as cefoxitin and ceftriaxone have been widely used as primary therapy for gonorrhea. The purpose of our study was to determine the susceptibility patterns of N. gonorrhoeae, collected from men seen at clinics in two urban Philadelphia neighborhoods, to five drugs commonly used in the treatment of gonorrhea: penicillin, tetracycline, spectinomycin, cefoxitin, and ceftriaxone. We also tested the activity of cefmetazole, a novel cephalosporin being used in clinical trials, as chemotherapy for gonorrhea. We determined the incidence of penicillin resistance due to ,-lactamase production, and we examined the relation between susceptibility to penicillin and susceptibility to other antibiotics among non-3-lactamase-producing strains. MATERIALS AND METHODSBetween March and October 1987, isolates of N. gonorrhoeae were collected from men seen at Episcopal Hospital and women seen at Temple University Hospital, both in north Philadelphia. The isolates were identified in the clinical microbiology laboratories by growth on Thayer-Martin agar, Gram stain appearance, oxidase activity, and coagglutination with monoclonal antibodies (Phadebact Monoclonal GC Omni Test; Pharmacia Diagnostics, Piscataway, N.J.) or by carbohydrate utilization (Fastidious Fermenters Duo Tubes and Trio Tubes; Carr-Scarborough Microbiologicals, Inc., Decatur, Ga.). Isolates were frozen at -70°C in 1-ml samples of Trypticase soy broth (BBL Microbiology Systems, Cockeysville, Md.) with 20% glycerol until they were thawed for batch susceptibility testing. The control strain was a laboratory isolate whose susceptibilities to penicillin and tetracycline were determined by agar dilution in a previous experiment (data not published). ,-Lactamase activity was * Corresponding author. determined by the chromogenic cephalosporin assay (Cefinase; B...

show abstract

“…Gonococcal strains that are resistant to penicillin, tetracycline, and the cephalosporins have been isolated (20,25). A strain belonging to the A/S class Pro/IB-1 and resistant to penicillin, tetracycline, erythromycin, and cefoxitin was isolated during an epidemic of gonorrhea in North Carolina in 1984 (20 ever, showed that strains belonging to several A/S classes exhibited chromosomal resistance to antimicrobial agents (25,48).…”

Section: Gonococcal Strain Populations In Communitiesmentioning

confidence: 99%

Molecular epidemiology of gonorrhea

Sarafian

Knapp

1989

Clin Microbiol Rev

View full text Add to dashboard Cite

Chromosomally Mediated Resistance in Neisseria gonorrhoeae in the United States: Results of Surveillance and Reporting, 1983-1984

Cited by 63 publications

References 0 publications

Trends in susceptibility of Neisseria gonorrhoeae to ceftriaxone from 1985 through 1991

Trends in susceptibility of Neisseria gonorrhoeae to ceftriaxone from 1985 through 1991

Susceptibility to cephalosporins of penicillin-susceptible and penicillin-resistant strains of Neisseria gonorrhoeae from Philadelphia

Molecular epidemiology of gonorrhea

Contact Info

Product

Resources

About