title: High-level quinolone resistance in Neisseria gonorrhoeae: a report of two cases.
abstract: OBJECTIVE
  Fluoroquinolones are widely used oral agents for treating Neisseria gonorrhoeae. Resistance to these agents is sporadic and usually at a low level. Two instances of high-dose ciprofloxacin regimens failing in the treatment of gonococcal infection, caused by strains with high-level quinolone resistance, are reported.
  
  
  METHODS
  This is a case report.
  
  
  CONCLUSIONS
  High-level resistance to quinolone antibiotics resulting in treatment failure was observed in two distinct gonococcal isolates from patients infected in the Philippines (ciprofloxacin; minimal inhibitory contribution = 16 mg/l). Continued monitoring of the quinolone sensitivity of Neisseria gonorrhoeae is appropriate and prudent.
authors.affiliation: Microbiology Department, Prince of Wales Hospital, Sydney, Australia.
authors.forename: J W
authors.initials: JW
authors.lastname: Tapsall
authors.forename: E A
authors.initials: EA
authors.lastname: Limnios
authors.forename: C
authors.initials: C
authors.lastname: Thacker
authors.forename: B
authors.initials: B
authors.lastname: Donovan
authors.forename: S D
authors.initials: SD
authors.lastname: Lynch
authors.forename: L J
authors.initials: LJ
authors.lastname: Kirby
authors.forename: K A
authors.initials: KA
authors.lastname: Wise
authors.forename: C J
authors.initials: CJ
authors.lastname: Carmody
mesh_terms: D042462:4-Quinolones; D000328:Adult; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D004352:Drug Resistance, Microbial; D024841:Fluoroquinolones; D006069:Gonorrhea / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests
chemical_list: D042462:4-Quinolones; D000890:Anti-Infective Agents; D024841:Fluoroquinolones