title: Antimicrobial resistance in Neisseria gonorrhoeae in the United States, 1988-1994: the emergence of decreased susceptibility to the fluoroquinolones.
abstract: Antimicrobial susceptibilities of Neisseria gonorrhoeae have been prospectively determined in the Gonococcal Isolate Surveillance Project of the Centers for Disease Control and Prevention. From 1988 through 1994, susceptibilities were determined for 35,263 isolates from 27 clinics. Patients were demographically similar to those in nationally reported gonorrhea cases. In 1994, 30.5% of isolates had chromosomally or plasmid-mediated resistance to penicillin or tetracycline. Penicillin resistance increased from 1988 (8.4%) to 1991 (19.5%) and then decreased in 1994 (15.6%). Tetracycline resistance decreased from 1988 (23.4%) to 1989 (17.3%) and then increased in 1994 (21.7%). Most isolates (99.9%) were highly susceptible to broad-spectrum cephalosporins. Isolates with decreased susceptibility to ciprofloxacin increased from 1991 (0.4%) to 1994 (1.3%); 4 isolates were ciprofloxacin-resistant. Ciprofloxacin-resistant strains may not respond to therapy with recommended doses of fluoroquinolones, and the clinical importance of strains with decreased susceptibility is unknown. The emergence of fluoroquinolone resistance in N. gonorrhoeae in the United States threatens the future utility of this class of antimicrobials for gonorrhea therapy.
authors.affiliation: Epidemiology and Surveillance Branch, National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
authors.forename: K K
authors.initials: KK
authors.lastname: Fox
authors.forename: J S
authors.initials: JS
authors.lastname: Knapp
authors.forename: K K
authors.initials: KK
authors.lastname: Holmes
authors.forename: E W
authors.initials: EW
authors.lastname: Hook
authors.forename: F N
authors.initials: FN
authors.lastname: Judson
authors.forename: S E
authors.initials: SE
authors.lastname: Thompson
authors.forename: J A
authors.initials: JA
authors.lastname: Washington
authors.forename: W L
authors.initials: WL
authors.lastname: Whittington
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use; D000890:Anti-Infective Agents / Q000494:pharmacology* / Q000627:therapeutic use; D002939:Ciprofloxacin / Q000494:pharmacology* / Q000627:therapeutic use; D004352:Drug Resistance, Microbial; D006069:Gonorrhea / Q000188:drug therapy / Q000382:microbiology*; D006801:Humans; D007769:Lactams; D008297:Male; D008826:Microbial Sensitivity Tests; D009344:Neisseria gonorrhoeae / Q000187:drug effects*; D014481:United States; D014521:Urethra / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D007769:Lactams; D002939:Ciprofloxacin