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)