title: Intercity spread of gonococci with decreased susceptibility to fluoroquinolones: a unique focus in the United States.
abstract: Patients and gonococcal isolates (n = 783) from five sexually transmitted disease clinics in Ohio and western Pennsylvania were studied to investigate the spread of gonococci with decreased fluoroquinolone susceptibility. Among patients with gonorrhea, rates of infection with strains with decreased fluoroquinolone susceptibility (MIC of 0.125-0.25 microg ciprofloxacin/mL) were 20% for Cleveland, 9% for Akron, 7% for Columbus, 1% for Toledo, and 0.5% for Pittsburgh. Persons infected with strains with decreased susceptibility were more likely than those with susceptible strains to be male and older; no significant differences in sex behaviors, residence of sex partners, or recent antibiotic use were detected. Prevalence of decreased susceptibility was not correlated with reported levels of community fluoroquinolone use. The Pro/IB-3 auxotype/serovar class accounted for 80% (44/55) of isolates with decreased susceptibility. Pro/IB-3 isolates from three cities had indistinguishable pulsed-field gel electrophoresis patterns, suggesting intercity spread of a clone.
authors.affiliation: National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. pbk4@cdc.gov
authors.forename: P H
authors.initials: PH
authors.lastname: Kilmarx
authors.forename: J S
authors.initials: JS
authors.lastname: Knapp
authors.forename: M
authors.initials: M
authors.lastname: Xia
authors.forename: M E
authors.initials: ME
authors.lastname: St Louis
authors.forename: S W
authors.initials: SW
authors.lastname: Neal
authors.forename: D
authors.initials: D
authors.lastname: Sayers
authors.forename: L J
authors.initials: LJ
authors.lastname: Doyle
authors.forename: M C
authors.initials: MC
authors.lastname: Roberts
authors.forename: W L
authors.initials: WL
authors.lastname: Whittington
mesh_terms: D000328:Adult; D000890:Anti-Infective Agents / Q000494:pharmacology*; D002939:Ciprofloxacin / Q000494:pharmacology*; D004269:DNA, Bacterial; D004352:Drug Resistance, Microbial; D016521:Electrophoresis, Gel, Pulsed-Field; D005260:Female; D006069:Gonorrhea / Q000453:epidemiology* / Q000382:microbiology; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D009344:Neisseria gonorrhoeae / Q000145:classification; D009820:Ohio / Q000453:epidemiology; D010414:Pennsylvania / Q000453:epidemiology
chemical_list: D000890:Anti-Infective Agents; D004269:DNA, Bacterial; D002939:Ciprofloxacin