Susceptibility pattern of Neisseria gonorrhoeae to antimicrobial agents in Dar es Salaam.
OBJECTIVE
To determine the susceptibility pattern of local strains of Neisseria gonorrhoeae from Dar es salaam, Tanzania to locally used antibiotics.


METHODS
Out of 429 Neisseria gonorrhoeae strains isolated between 1993 and 1995, one hundred and ninety nine were recovered and tested. Minimum inhibitory concentrations (MIC) of penicillin, doxycycline, erythromycin, cefuroxime and ciprofloxacin were determined by the E-test method while that of spectinomycin was measured by the agar dilution method. Penicillinase producing N. gonorrhoeae were identified by the chromogenic cephalosporin method.


RESULTS
Of the 199 strains tested 128 (64%) were found to be penicillinase producing Neisseria gonorrhoeae (PPNG). Only 19 (10%) were penicillin sensitive while all penicillin resistant strains were found to be PPNG. One hundred and seventy five (88%), 11(5%) and 13 (7%) of the tested isolates were resistant, less susceptible and fully susceptible to doxycycline respectively. Resistance to cotrimoxazole, cefuroxime and ciprofloxacin was 36 (18%), 11 (6%), and 3 (2%) respectively. The trend of antibiotic susceptibility rates over the three year period of study showed a significant increase in the proportion of susceptible strains to cotrimoxazole. All of the 75 strains tested against spectinomycin were susceptible. There was a statistically significant difference between the susceptibility patterns of non-PPNG and PPNG. Non-PPNG isolates were more susceptible to doxycycline (chi 2 = 78.2, df 2, p = < 0.0001).


CONCLUSIONS
These findings have shown that spectinomycin, ciprofloxacin and cefuroxime could continue to be used to treat gonorrhoea in our settings. Continuous surveillance of susceptibility to the commonly used antibiotics is important in order to detect emergence of resistance early and control the possible wide spread of resistant strains.
Mbwana
J
J
Muhimbili Hospital, Dar es Salaam, Tanzania.
Mhalu
F
F
Mwakagile
D
D
Masesa
J
J
Moshiro
C
C
Sandstrom
E
E
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003906:Developing Countries; D016903:Drug Monitoring; D004352:Drug Resistance, Microbial; D004363:Drug Utilization; D006069:Gonorrhea / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D006801:Humans; D008826:Microbial Sensitivity Tests; D009344:Neisseria gonorrhoeae / Q000187:drug effects*; D018579:Patient Selection; D011159:Population Surveillance; D013636:Tanzania / Q000453:epidemiology; D014504:Urban Health / Q000706:statistics & numerical data
D000900:Anti-Bacterial Agents