Antibiotic susceptibility of Neisseria gonorrhoeae in Trinidad and Tobago

Treatment failures with standard doses of penicillin have been observed in the Sexually Transmitted Diseases (STD) clinics in Trindad and Tobago. In the absence of an ongoing surveillance system, the antimicrobial susceptibility of 518 Neisseria gonorrhoeae strains was determined in order to guide treatment. 39 (7.6 percent) strains were resistant to penicillin, including 27 (5.2 percent) positive for beta-lactamase; that is penicillinase-producing Neisseria gonorrhoeae (PPNG). 51 (10 percent) strains were resistant to tetracycline, with 26 (5.0 percent) of these exhibiting high levels of resistance compatible with tetracycline resistant Neisseria gonorrhoeae (TRNG). Six strains showed evidence of having both PPNG and TRNG plasmids, and five strains showed chromosomally-mediated resistance to both penicillin and tetracycline. The overall resistance rate to penicillin and tetracycline was 17.7 percent. There was no resistance to spectinomycin, cefuroxine, ceftriaxone and norfloxacin. The resistance rates demonstrated in this study are sufficently significant to preclude the use of penicillin and tetracycline in the STD clinics and to justify the use of newer antimicrobials. It is essential that resistance patterns be monitored by continued surveillance.(AU)

Antibiotic susceptibility of Neisseria gonorrhoeae in Trinidad and Tobago

Treatment failures with standard doses of penicillin have been observed in the Sexually Transmitted Diseases (STD) clinics in Trinidad and Tobago. In the absence of an ongoing surveillance system, the antimicrobial susceptibility of 518 Neisseria gonorrhoeae strains was determined in order to guide treatment. 39 (7.6) strains were resistant to penicillin, including 27 (5.2) positive for beta-lactamase; that is penicillinase-producing Neisseria gonorrhoeae (PPNG). 51 (10) strains were resistant to tetracycline, with 26 (5.0) of these exhibiting high levels of resistance compatible with tetracycline resistant Neisseria gonorrhoeae (TRNG). Six strains showed evidence of having both PPNG and TRNG plasmids, and five strains showed chromosomally-mediated resistance to both penicillin and tetracycline. The overall resistance rate to penicillin and tetracycline was 17.7. There was no resistance to spectinomycin, cefuroxime, ceftriaxone and norfloxacin. The resistance rates demonstrated in this study are sufficiently significant to preclude the use of penicillin and tetracycline in the STD clinics and to justify the use of newer antimicrobials. It is essential that resistance patterns be monitored by continued surveillance.

Antibiotic susceptibility of Neisseria gonorrhoeae in Trinidad and Tobago.

Treatment failures with standard doses of penicillin have been observed in the Sexually Transmitted Diseases (STD) clinics in Trinidad and Tobago. In the absence of an ongoing surveillance system, the antimicrobial susceptibility of 518 Neisseria gonorrhoeae strains was determined in order to guide treatment. 39 (7.6%) strains were resistant to penicillin, including 27 (5.2%) positive for beta-lactamase; that is penicillinase-producing Neisseria gonorrhoeae (PPNG). 51 (10%) strains were resistant to tetracycline, with 26 (5.0%) of these exhibiting high levels of resistance compatible with tetracycline resistant Neisseria gonorrhoeae (TRNG). Six strains showed evidence of having both PPNG and TRNG plasmids, and five strains showed chromosomally-mediated resistance to both penicillin and tetracycline. The overall resistance rate to penicillin and tetracycline was 17.7%. There was no resistance to spectinomycin, cefuroxime, ceftriaxone and norfloxacin. The resistance rates demonstrated in this study are sufficiently significant to preclude the use of penicillin and tetracycline in the STD clinics and to justify the use of newer antimicrobials. It is essential that resistance patterns be monitored by continued surveillance.

PIP: Neisseria gonorrhoeae from many areas of the world have developed resistance to a wide variety of antibiotics over the past 2 decades. The incidence of treatment failures with standard doses of penicillin observed in Trinidad and Tobago's sexually transmitted disease (STD) clinics suggests that such resistance also exists in Trinidad. 518 Neisseria gonorrhoeae strains were isolated from 1502 male and female patients attending the 7 STD clinics throughout Trinidad during May-October 1992, and tested to identify their antimicrobial susceptibility. 39 strains were resistant to penicillin, including 27 which were positive for beta-lactamase, indicating infection with penicillinase-producing Neisseria gonorrhoeae (PPNG). 51 strains were resistant to tetracycline, of which 26 exhibited high levels of resistance compatible with tetracycline-resistant Neisseria gonorrhoeae (TRNG). 6 strains showed evidence of having both PPNG and TRNG plasmids, and 5 strains showed chromosomally-mediated resistance to both penicillin and tetracycline. The overall resistance rate to penicillin and tetracycline was 17.7%, and there was resistance to neither spectinomycin, cefuroxime, ceftriaxone, nor norfloxacin. The resistance rates observed in this study are significant enough to warrant the cessation of penicillin and tetracycline use in STD clinics, and the use of newer antimicrobials. Neisseria gonorrhoeae resistance patterns demand ongoing monitoring.

Susceptibility of neisseria gonorrhoeae to selected antimicrobial agents in Trinidad and Tobago - abstract

Treatment failures of 20 percent with standard doses of penicillin have been observed in our sexually transmitted disease (STD) clinics in the treatment of gonorrhoea. A large number of Neisseria gonorrhoeae strains (547) from various STD clinics were tested against selected antimicrobials in order to determine the most appropriate alternative treatment regimen. Using an agar dilution technique and testing for the presence of beta-lactamase production, it was determined that less than 1 percent of Neisseria gonorrhoeae strains were sensitive to penicillin, 85 percent were moderately sensitive and 15 percent were completely resistant to penicillin. More than 5 percent of the strains produced beta-lactamase. Tetracycline resistance was seen in 57 percent of the strains, and 7.3 percent of the strains were resistant to cefuroxime. There was no resistance to spectinomycin, ceftriaxone or norfloxacin. STD clinics in Trinidad and Tobago can no longer rely on penicillin and tetracycline in the treatment gonorrhoea. Protocols will have to include spectinomycin, ceftriaxone or norfloxacin (AU)