Gonococcal infection within Scotland: Antigenic heterogeneity and antibiotic susceptibility of infecting strains

Abstract

Two panels of monoclonal antibody reagents were used to serotype all strains of Neisseria gonorrhoeae isolated from four separate geographical areas serving two million of the five million Scottish population. Serotype 1B isolates accounted for 60% of the 869 strains examined and were more prevalent than 1A isolates in each geographical area. A total of 11 1A serovars and 47 1B serovars were recognised. Only two of the 11 1A serovars (Aedgkih/Arost and Aedih/Arst) were found in every centre but these accounted for over 90% of the 1A isolates. Although there was a total of 47 different 1B serovars over 80% of the isolates were accounted for by the ten most commonly encountered serovars. There were, however, marked geographical differences within both major and minor serovars. There was a highly significant difference (P less than 0.001) between protein 1A and 1B serovars with respect to their susceptibility to penicillin. Within each protein 1 type there were also differences in antibiotic susceptibility. Penicillinase-producing N. gonorrhoeae (PPNG) were found in all centres and accounted for 24 (2.8%) of the 869 isolates. The majority of the PPNG (71%) were serotype 1A and with one exception were serovar Aedih/Arst. PPNG strains accounted for 37% (16) of the 43 Aedih/Arst isolates. Epidemiological, diagnostic and therapeutic implications arising from the distinct geographical differences in the pool of circulating gonococci are discussed.

Prediction of antibiotic resistance using Neisseria gonorrhoeae multi-antigen sequence typing

“…Antibiotic sensitivity to seven antibiotics (azithromycin 0.015–2 mg/l, cefixime 0.015–0.12 mg/l, ceftriaxone 0.015–0.12 mg/l, ciprofloxacin 0.004–1 mg/l, penicillin 0.015–2 mg/l, spectinomycin 16–128 mg/l and tetracycline 0.25–4 mg/l) was determined using the agar dilution method 7. E-tests (AB Biodisk, Sweden) were also performed according to the manufacturer’s instructions for those isolates with a ciprofloxacin MIC of 0.125 mg/l or greater and for any isolate with an MIC that exceeded the range of the antibiotic dilution series.…”

The epidemiology of ciprofloxacin resistant isolates of Neisseria gonorrhoeae in Scotland 2002: a comparison of phenotypic and genotypic analysis

“…10 Antibiotic sensitivity to six antibiotics (azithromycin 0.015-2 mg/l, ceftriaxone 0.015-0.12 mg/l, ciprofloxacin 0.004-1 mg/l, penicillin 0.015-2 mg/l, spectinomycin 16-128 mg/l, and tetracycline 0.25-4 mg/l) was measured using the agar dilution method. 11 E-tests (AB Biodisk, Sweden) were also carried out for those isolates with ciprofloxacin MIC values >0.125 mg/l, or MIC values for other antibiotics that extended beyond the dilution series. Isolates with a penicillin MIC value .2 mg/l and/or a positive acidometric test were tested for b lactamase activity using the nitrocephin test.…”

Gonococcal infection in Edinburgh and Newcastle: serovar prevalence in relation to clinical features and sexual orientation.

“…This implies that the success of a "new" strain within any particular community would depend on that community's previous exposure and may explain the differences observed in this and other studies which have compared serovar patterns in different geographical areas of even relatively close proximity. 5 Over the past decade the incidence of gonorrhoea has fallen dramatically in many parts of the Western world'4 although there has recently been an increase reported in England and Wales. 15 No such increase has thus far occurred in Edinburgh, with the exception of an unsustained rise in homosexually acquired gonorrhoea,'6 but the observed decline in the incidence of gonorrhoea has plateaued (unpublished data).…”