title: Auxotypes, serovars, and trends of antimicrobial resistance of Neisseria gonorrhoeae in Kigali, Rwanda (1985-93).
abstract: OBJECTIVE
  To investigate the in vitro antimicrobial susceptibility and the auxotype/serovar distribution of Neisseria gonorrhoeae in Kigali, Rwanda, during 1985-93.
  
  
  METHODS
  As part of a monitoring programme the in vitro susceptibility of 1604 isolates of N gonorrhoeae was determined by agar dilution. Auxo- and serotyping was performed on 1350 and 1313 isolates respectively.
  
  
  RESULTS
  The prevalence of penicillinase producing N gonorrhoeae (PPNG) remained stable at a rate of 39% during 1985-91 and increased to 61% in 1992-3. Chromosomal resistance to penicillin was common among non-PPNG and resistance to thiamphenicol and tetracycline was common among both PPNG and non-PPNG. High level, plasmid mediated resistance to tetracycline (TRNG) was observed for the first time at the end of 1989 and increased from 2% of the isolates in 1990 to 50% by 1993. A trend for increasing resistance to norfloxacin and ofloxacin was observed during 1985-90 but disappeared in 1991-93. Five isolates with high level resistance to norfloxacin (MIC 2 mg/l) were observed in 1990. Resistance to trimethoprim-sulphamethoxazole (TMP-SMZ) emerged at the end of 1990 and was observed among 10% of the isolates during 1991-3. All strains remained susceptible to ofloxacin, ciprofloxacin, spectinomycin, and ceftriaxone. Overall, 75% of the isolates were prototrophic or required proline for their growth and 62% belonged to serovars IA-6 and IB-1. The prevalence of serovar IB-4 increased strongly during the last 3 years of the study.
  
  
  CONCLUSIONS
  Resistance to penicillin, thiamphenicol, and tetracycline was common in N gonorrhoeae during 1985-1993. The rapid spread of TRNG after 1989 and the steep increase of PPNG during 1992-3 were the most striking facts of the study period. The auxotype and serovar distribution was comparable with findings from other African countries.
authors.affiliation: Centre Hospitalier de Kigali, Rwanda.
authors.forename: J
authors.initials: J
authors.lastname: Bogaerts
authors.forename: E
authors.initials: E
authors.lastname: Van Dyck
authors.forename: B
authors.initials: B
authors.lastname: Mukantabana
authors.forename: J P
authors.initials: JP
authors.lastname: Munyabikali
authors.forename: W
authors.initials: W
authors.lastname: Martinez Tello
mesh_terms: D018432:Drug Resistance, Multiple; D005260:Female; D006069:Gonorrhea / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D009344:Neisseria gonorrhoeae / Q000187:drug effects* / Q000201:enzymology; D010403:Penicillin Resistance; D010405:Penicillinase / Q000378:metabolism; D015995:Prevalence; D012432:Rwanda / Q000453:epidemiology; D012703:Serotyping / Q000379:methods
chemical_list: D010405:Penicillinase