Patterns of antibiotic susceptibility of gonococci ...

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Title Patterns of antibiotic susceptibility of gonococci isolated in Hong Kong, 1987-1990
Author(s) K. M. Kam, C. F. Lai, S. Egglestone, Catherine B. Chan
Journal Sexually Transmitted Diseases
Date 1992
Volume 19
Issue 5
Start page 284
End page 287
Abstract Among the 14,528 strains of Neisseria gonorrhoeae isolated from the Government Social Hygiene Sexually Transmitted Disease (STD) Clinics in Hong Kong between 1987 and 1990, there has been a trend toward a decrease in the percentage of penicillin resistant strains in both penicillinase-producing and nonpenicillinase producing N. gonorrhoeae (PPNG and non-PPNG) and an increase in moderate resistant strains, whereas the proportion of sensitive strains has remained stable, except for a small increase in 1990. Presently, PPNG still accounts for 31% of all isolates. In early 1991, 100 consecutive isolates were tested for minimum inhibitory concentrations (MIC) against 6 commonly used antibiotics. Although ofloxacin has been used as the first-line treatment for gonorrhea for the last 5 years, there is still no sign of in vitro resistance. Two isolates with high-level tetracycline resistance (MIC greater than 16 mg/l) were detected that have not been seen before. Sensitivity to spectinomycin, cefuroxime, and ceftriaxone has also been maintained, and these drugs can probably be recommended as alternative treatments in noncompliant cases. Analysis of location of contact shows an increasing proportion of cases of gonorrhea from overseas, particularly from parts of China. Comparison with the limited information published in the region shows that the population sampled can be very heterogeneous. With the continued flux of international travel, one should be extremely careful when trying to get an accurate assessment of epidemiologic data.; PIP: Laboratory researchers identified 14,528 strains of Neisseria gonorrhoeae isolated from lower to middle class patients who attended the Government Social Hygiene Sexually Transmitted Disease Clinics in Hong Kong between 1987-90. They also used 100 strains collected during the 1st part of 1991 as control strains. They wanted to determine patterns of antibiotic susceptibility. The number of positive isolates fall from 5971 to 2039 during the study period. The percentage of strains sensitive to penicillin did not differ greatly (4.5% in 1987 and 1989, 3.4% in 1988, and 6% in 1990). On the other hand, the percentage of moderately resistant strains rose from 15.2% to 32%. The percentage of penicillinase-producing N. gonorrhoeae (PPNG) and nonpenicillinase-producing N. gonorrhoeae decreased from 38.7% to 31% and 41.1% to 30.9%, respectively. The control strains exhibited considerable sensitivity to ofloxacin, the antibiotic of choice for treating uncomplicated gonorrhea, as well as spectinomycin and ceftriaxone. 2 strains were very resistant to tetracycline which, in the past, did not exhibit this resistance. Most patients from whom samples were taken lived in Hong Kong (79% in 1987 and 61% in 1990), but the percentage of foreign patients grew (21-39%) which was simultaneous with the worldwide growth in international trade and travel. Most of these foreigners came to Hong Kong from Macau (50% in 1987 and 49% in 1990) and China (14% in 1987 and 32% in 1990). The population served by the clinics apparently acquire the N. gonorrhoeae strains from nearby areas. Future studies should include samples from private clinics which tend to serve the widely traveled groups to obtain an accurate assessment of the real strain population of Hong Kong.

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