Experience with Various Antibiotics for Treatment of Anorectal Gonorrhea

Ae, Washington

doi:10.1097/00007435-197904000-00020

Cited by 18 publications

(3 citation statements)

References 25 publications

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“…Anorectal gonococcal infections are more difficult to treat with certain antibiotics in homosexual men than in heterosexual women (30). Several explanations have been proposed for this difference.…”

Section: Discussionmentioning

confidence: 99%

Gonococcal strains from homosexual men have outer membranes with reduced permeability to hydrophobic molecules

Morse¹,

Lysko²,

McFarland³

et al. 1982

Infect Immun

113

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Loci designated penA, penB, and mtr contribute additively to penicillin G resistance in Neisseria gonorrhoeae; the mtr locus also confers resistance to hydrophobic dyes, detergents, and antibiotics. env mutations suppress the phenotypic expression of mtr and penB and are responsible for increased sensitivity to various hydrophobic molecules. We postulated that the host environment is important in the selection of gonococcal strains with these particular outer membrane phenotypes. Thus, mtr strains should predominate in environments that are high in hydrophobic molecules. To test this hypothesis we determined the outer membrane phenotype of 152 strains of N. gonorrhoeae. Rectal and urethral isolates from 58 homosexual men, urethral isolates from 55 heterosexual men, and cervical and rectal isolates from 39 heterosexual women were used in this study. Strains from 43 of the homosexual men were matched with those from heterosexual men with respect to auxotype and year and season of isolation. Cell envelope phenotype was determined for each strain on the basis of its resistance to various hydrophobic compounds. The identity of mtr strains was confirmed by genetic transformation. Among the matched pairs, mtr strains were significantly more prevalent among isolates from homosexual men than among those from heterosexual men (P = 0.03). Serogrouping by coagglutination demonstrated that 17 of 19 mtr strains versus 76 of 131 non-mtr strains belonged to coagglutination group WII (P = 0.01). Coagglutination group WII strains were also associated with homosexuality (P = 0.02). Gonococci were also tested for resistance to fecal lipids. mtr strains were more resistant to growth inhibition by fecal lipids than were non-mtr strains. The outer membrane of gram-negative bacteria serves as an initial osmotic barrier between the environment and the plasma membrane (28). The asymmetric structure of this membrane renders it relatively impermeable to small hydrophobic molecules, such as detergents, dyes, and drugs, and contributes to the resistance of gramnegative organisms to certain antibiotics (33). The outer membrane of Neisseria gonorrhoeae is more permeable than that of other gramnegative bacteria to hydrophobic dyes and fatty acids (17, 18). Genetic loci designated penA, penB, and mtr contribute additively to penicillin G resistance in N. gonorrhoeae; the mtr locus also confers resistance to hydrophobic dyes and

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Section: Discussionmentioning

confidence: 99%

Gonococcal strains from homosexual men have outer membranes with reduced permeability to hydrophobic molecules

Morse¹,

Lysko²,

McFarland³

et al. 1982

Infect Immun

113

View full text Add to dashboard Cite

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“…In view of the possibility that anorectal gonorrhea in women may not respond as readily as endocervical gonorrhea to some recommended treatment regimens (17), a test of cure should continue to employ both cervical and anal-canal specimens on separate plates. According to Schroeter and Reynolds (14), up to one-third (29/96) of therapeutic failures will be missed if a single endocervical specimen is relied on as a test of cure.…”

Section: Discussionmentioning

confidence: 99%

Combining cervical and anal-canal specimens for gonorrhea on a single culture plate

Judson¹,

Werness²

1980

J Clin Microbiol

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To reduce the cost of detecting gonorrhea, we studied the effect on diagnostic sensitivity of combining two culture specimens on the same plate of modified Thayer-Martin medium, using specimens from 7,787 women seen consecutively in the clinic. There was no significant difference (P greater than 0.05) between one cervical and one anal-canal specimen placed on separate plates (C,A) and these two specimens combined but spaced apart on a single plate (C/A), or between two cervical specimens combined but spaced apart on the same plate (C/C) and C/A. Therefore, C/C, C/A, and C,A have equivalent diagnostic sensitivities. C/A detected 5.68% more women with gonorrhea than did a single cervical culture (C) (P less than 0.001). If C/A were to replace C,A for culture specimens from women seen in venereal disease clinics and C for specimens taken and cultured outside of venereal disease, gonorrhea control programs in the United States could realize savings in excess of $2.5 million per year.

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“…In the past, time and expense have been deterrents to the routine culturing of pharyngeal and anal sites. Some investigators have stated that multiple-site culturing is not justifiable on the basis of cost-effectiveness (1,6,15).…”

mentioning

confidence: 99%

Cost-effective method of triple-site culturing for Neisseria gonorrhoeae

Gartner¹,

Edwards²

1984

J Clin Microbiol

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The efficacy of the use of a single modified Thayer-Martin triplate versus that of three separate modified Thayer-Martin plates for the recovery of Neisseria gonorrhoeae from pharyngeal, anal, and genital sites were studied. A total of 98 males and 74 females who showed intracellular gram-negative diplococci on genital Gram stain were studied. Of 172 patients, 164 had gonorrhea at one or more sites. In the first group of 45 males and 21 females, a single swab from each site was used to inoculate randomly both a standard plate (100 mm in diameter) and one-third of a triplate. In the second group of 53 males and 53 females, two swabs were used for collection from each site. One of each pair of swabs was randomly inoculated onto a standard plate and a triplate. There was no significant difference between the results obtained by inoculation with single swabs and those obtained by inoculation with two swabs. There were no significant differences between the positivity rates obtained with the triplate and those obtained with three standard plates used at each site. Cost (39% that of three separate plates) and acceptance by clinic and laboratory personnel make the triplate method an economical, accurate, and effective triple-site screening system.

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Experience with Various Antibiotics for Treatment of Anorectal Gonorrhea

Cited by 18 publications

References 25 publications

Gonococcal strains from homosexual men have outer membranes with reduced permeability to hydrophobic molecules

Gonococcal strains from homosexual men have outer membranes with reduced permeability to hydrophobic molecules

Combining cervical and anal-canal specimens for gonorrhea on a single culture plate

Cost-effective method of triple-site culturing for Neisseria gonorrhoeae

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