Treatment of gonorrhoea and susceptibility to antimicrobials of PPNG and non-PPNG strains in Jamaica

Of 1400 patients in Jamaica screened for uncomplicated gonorrhoea, 54 percent (753 patients) were culture positive. Of the 459 patients who complied with the terms of the study, 97 percent (211/218) of those treated with ampicillin G were cured compared with 94 percent (227/241) of those treated with ampicillin. Penicillinase producing Neisseria gonorrhoeae (PPNG) strains were identified for the first time during the study, and 10 patients infected with PPNG strains (two treated with penicillin, eight with ampicillin) contributed to the 21 treatment failures. The in vitro susceptibility of eight antimicrobial agents for 629 non-PPNG and 20 PPNG strains was estimated. Of the non-PPNG isolates, 8 percent had an Mic of 1mg/1 or more of pencillin, 11 percent were resistant to this concentration of cefuroxime 32 percent to tetracycline, and under 1 percent to the same concentration of cefuroxime and erythromycin. Fever than 2 percent of the isolates were resistant to 2 mg/1 or more thiamphenicol, and all isolates were susceptible to spectinomycin and trimethiprimsulphamethoxazole (at a ratio of 1:19). Significantly more strains from the 21 treatment failures were resistant to penicillin (52 percent) or ampicillin (62 percent) compared with 7 percent strains resistant to pencillin and 4 percent to ampicillin from the successfully treated group.(AU)

Auxotypes, plasmid contents, and serovars of gonococcal strains (PPNG and non-PPNG) from Jamaica.

The analysis of the auxotypes and plasmid profiles of 459 non-PPNG strains from Jamaica suggest that strains have been imported to the island. Unlike in many developing countries where strains are differentiated by only a few auxotypes, 13 different auxotypes were identified in the non-PPNG strains. In Jamaica over 10 percent of the strains were plasmid free and required proline, citrulline, and uracil (PCU-)for growth. These isolates predominate in Canada and are increasingly reported from areas of the United States of America and Europe. The serological analysis of 168 of the non-PPNG strains indicated that most (76 percent, 128) were from serogroup WII/III. Serogroup WII/III strains comprised 17 serovar combinations with GS and PH reagents, whereas serogroup WI strains included only four serovars. Unusually, most WI Aedgkih non-PPNG strains were wild type or proline requiring. Strains of serovar Aedg were especially noted (in 93 percent, 13/14) for carriage of the transfer plasmid. The first 20 PPNG strains isolated in Jamaica proved to have multiple origins as they had eight variations of auxotype, serovar, and plasmid content. Most (60 percent, 12/20) of those isolated were typed as serogroup WI, and 10 of these isolated were serovar Aedfkih. Although most (70 percent, 14/20) PPNG strains harboured African type plasmids with or without transfer plasmids, six also carried Asian type plasmids (with the transfer plasmid).(AU)