Antimicrobial susceptibilities of Neisseria gonorrhoeae in Kigali, Rwanda, and trends of resistance between 1986 and 2000.
BACKGROUND
Plasmid-mediated and chromosomal-mediated resistance of Neisseria gonorrhoeae to penicillin, tetracycline, thiamphenicol, and trimethoprim-sulfamethoxazole has spread dramatically in Africa. Monitoring of antimicrobial susceptibility is a key element in the control of sexually transmitted diseases.


OBJECTIVE
To document antimicrobial susceptibilities of gonococci isolated during the past 15 years in Kigali, Rwanda.


METHODS
Minimal inhibitory concentrations of recently collected gonococcal isolates of eight antimicrobials were determined. The results were compared with data collected for isolates obtained since 1986.


RESULTS
In 1986, 35% of the gonococcal isolates were penicillinase-producing N gonorrhoeae. Tetracycline-resistant N gonorrhoeae appeared in 1989. The prevalence of penicillinase-producing N gonorrhoeae and tetracycline-resistant N gonorrhoeae increased significantly to 70.5% and 89.2%, respectively. Chromosomal resistance to penicillin, tetracycline, and thiamphenicol increased temporarily, then decreased significantly. Chromosomal resistance to trimethoprim-sulfamethoxazole appeared in 1988 and increased to 21.6%. All the isolates were susceptible to ceftriaxone, ciprofloxacin, spectinomycin, and kanamycin.


CONCLUSIONS
This study illustrated the rapidly increasing frequencies of penicillinase-producing N gonorrhoeae and tetracycline-resistant N gonorrhoeae. Chromosomal resistance to thiamphenicol and trimethoprim-sulfamethoxazole excludes these drugs as alternative treatment. Programs for antimicrobial susceptibility surveillance of N gonorrhoeae should urgently be established in Africa.
Van Dyck
E
E
Institute of Tropical Medicine, Antwerp, Belgium. evandyck@itg.be
Karita
E
E
Abdellati
S
S
Dirk
V H
VH
Ngabonziza
M
M
Lafort
Y
Y
Laga
M
M
D004352:Drug Resistance, Microbial / Q000235:genetics; D006069:Gonorrhea / Q000188:drug therapy*; D006801:Humans; D008826:Microbial Sensitivity Tests / Q000379:methods; D009344:Neisseria gonorrhoeae / Q000187:drug effects* / Q000302:isolation & purification; D010403:Penicillin Resistance; D012432:Rwanda / Q000453:epidemiology; D018571:Sentinel Surveillance