Treatment Failure with the Use of Ciprofloxacin for Gonorrhea Correlates with the Prevalence of Fluoroquinolone-Resistant Neisseria gonorrhoeae Strains in Bangladesh

Abstract

Although ciprofloxacin is one of the recommended drugs of choice for the treatment of gonorrhea, in vitro resistance to this drug has been observed in surveillance studies and case reports from many parts of the world, including Bangladesh. However, to our knowledge, there have been no prospective studies of the correlation between in vitro response to the drug and treatment outcome. Therefore, a prospective study of 217 female sex workers in Dhaka, Bangladesh, was conducted to examine the correlation between the in vitro response of Neisseria gonorrhoeae and the outcome of ciprofloxacin treatment. Overall, 37.8% of the gonococcal isolates recovered from female sex workers were resistant to ciprofloxacin, and there was a good correlation between in vitro resistance and treatment failure. These findings suggest that in vitro resistance to ciprofloxacin is predictive of clinical treatment failure in patients with gonorrhea.

Specific andSensitive Detection of Neisseria gonorrhoeae in ClinicalSpecimens by Real-Time PCR

“…Culturing and determination of N. gonorrhoeae identity were performed at the Public Health Laboratory in Amsterdam as described previously (8). In the context of a communal epidemiology study, we typed these N. gonorrhoeae strains by PCR-restriction fragment length polymorphism of the opa and por genes, further confirming that true N. gonorrhoeae strains were used for DNA isolation (24,29).…”

Multicenter Validation of the cppB Gene as a PCR Target for Detection of Neisseria gonorrhoeae

“…DNA was isolated from a few colonies by isopropanol precipitation, and the pellet was dissolved in 50 l of T10 buffer (10 mM Tris-HCl, pH 8.0) (9). In the context of a communal epidemiology study, we typed these N. gonorrhoeae strains by PCR-restriction fragment length polymorphism analysis of the opa and por genes, confirming further that true N. gonorrhoeae strains were used for DNA isolation (7,10). A coded panel of 500 samples was composed by distributing 50 negative samples randomly among 450 DNA preparations of confirmed N. gonorrhoeae strains.…”

Molecular Epidemiology of Neisseria gonorrhoeae in Amsterdam, The Netherlands, Shows Distinct Heterosexual and Homosexual Networks

“…Developments in molecular typing techniques can improve accuracy, and various new methods have already been evaluated in the search for discriminatory techniques to differentiate strains circulating in a population (12,17,23). The Neisseria gonorrhoeae por and opa genes, encoding the porin and opacity proteins, respectively, have proven helpful for genotyping N. gonorrhoeae (6,15,16), revealing links between individuals and identifying common social venues (2,5,25,26).…”