National surveillance of antimicrobial resistance in Neisseria gonorrhoeae

Article Abstract:

Gonorrhea is caused by the bacterial organism Neisseria gonorrhoeae, and although the incidence of this sexually transmitted disease has fallen since 1975, strains of the organism that are resistant to standard antibiotics have become increasingly difficult to eradicate. The Gonococcal Isolate Surveillance Project is a national sentinel system that examines the sensitivity to various antibiotics of individual gonorrheal organisms isolated from public sexually transmitted disease clinics. The samples used in this report were collected between September 1987 and December 1988; 6,204 different specimens were analyzed for sensitivity, of which 21 percent were found to be resistant to at least one of the following drugs: penicillin, tetracycline, cefoxitin, or spectinomycin. Some isolates produced an enzyme, penicillinase, that was specifically able to chemically alter penicillin. All samples were sensitive to ceftriaxone. No pattern of patient demographics or behavior emerged that could be associated with infections of resistant strains of Neisseria gonorrhoeae. Samples of resistant strains were received from all 21 clinical sites, indicating that resistant strains of the organism are spread geographically across the United States. These results underscore the need for recent changes made in recommendations by the Centers for Disease Control concerning drug therapy for gonorrhea. The current first-line therapy is a single 250-mg dose of ceftriaxone administered by a muscle injection combined with another antibiotic, doxycycline, taken orally at 100 mg twice daily for one week. Thus, the present therapeutic recommendation is to treat all cases of gonorrhea as if they were resistant. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Antibiotics, Surveys, Drug therapy, Drug resistance in microorganisms, Microbial drug resistance, Identification and classification

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Localized outbreak of penicillinase-producing Neisseria gonorrhoeae: paradigm for introduction and spread of gonorrhea in a community

Article Abstract:

The U.S. rate of infection due to penicillinase-producing Neisseria gonorrhea, PPNG, (sexually transmitted gonorrhea bacteria which has developed resistance to the usual penicillin treatment) has increased dramatically since 1985; Florida, California, and New York have reported the greatest numbers of cases. Researchers studied the rise in PPNG cases in King County, Washington (metro- Seattle) from 1982 through 1987. As the strain of the disease spread, the bulk of the cases shifted from whites to Afro-Americans, and from men to equal numbers of men and women. Youth and those living below the poverty level were also at risk for contracting PPNG. Sex with a prostitute or IV drug user was associated with a high risk of receiving or transmitting the disease. The association between illicit drug use and PPNG cases rose from 19 percent during the first quarter of 1987 to 82 percent by the fourth quarter of that year. The epidemic of PPNG began to decline, in part, due to a broad-based public health efforts emphasizing treatment and prevention. It has also been hypothesized that the decline in the incidence of PPNG was related to naturally occurring factors that limit transmission and spread of infection, such as acquisition of strain-specific immunity in the affected population. Nationally, the incidence of PPNG infection is rising; it now exceeds 4 percent of reported gonorrhea cases.

Health aspects, Sexually transmitted diseases, Statistics, Demographic aspects, King County, Washington, Washington (State)

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Effect of expedited treatment of sex partners on recurrent or persistent gonorrhea or chlamydial infection

Article Abstract:

Women and heterosexual men are randomly assigned with gonorrhea or chlamydial infection to have their partners receive expedited treatment or standard referral. It is found that expedited treatment of sex partners reduces the rates of persistent or recurrent gonorrhea or chlamydial infection.

Science & research, Research, Risk factors, Chlamydia infections

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