title: Antibiotic resistant N. gonorrhoeae in Trinidad and Tobago.
abstract: We tested the susceptibility patterns of 128 N. gonorrhoeae isolates to six antimicrobials; penicillin, tetracycline, spectinomycin, ceftriaxone, ciprofloxacin and azithromycin, and examined whether certain demographic or behavioral factors related to antibiotic use increased the likelihood of infection by a resistant strain. There was a low rate of resistance to penicillin; penicillinase-producing and chromosomal-mediated penicillin resistant gonorrhea were estimated to be 0.8%. A much higher proportion of isolates were resistant to tetracycline (up to 15%). All isolates were sensitive to spectinomycin, ciprofloxacin and ceftriaxone. However, less than 2% of isolates displayed intermediate resistance to both ciprofloxacin and ceftriaxone, and 9% exhibited intermediate resistance to spectinomycin. Patients who had obtained medication before attending the clinic and had taken all of the medication were more likely (p = 0.03) to be infected with a resistant strain of gonococcus. Also, patients who were asked by a clinic doctor to return for a test of cure during an earlier clinic visit, but who did not return were more likely to be infected with a resistant organism (p = 0.006) compared to those who returned at the doctor's request. These findings have important implications for antibiotic use and educational programs in Trinidad and Tobago.
authors.affiliation: Department of Epidemiology and International Health, School of Public Health and Medical Statistics Section, University of Alabama at Birmingham, 35294-0022, USA.
authors.forename: D
authors.initials: D
authors.lastname: Castor
authors.forename: P
authors.initials: P
authors.lastname: Prabhakar
authors.forename: C
authors.initials: C
authors.lastname: Furlonge
authors.forename: A
authors.initials: A
authors.lastname: Rao
authors.forename: A
authors.initials: A
authors.lastname: Brown
authors.forename: B
authors.initials: B
authors.lastname: Camara
authors.forename: H
authors.initials: H
authors.lastname: Weiss
authors.forename: P E
authors.initials: PE
authors.lastname: Jolly
mesh_terms: D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000494:pharmacology* / Q000627:therapeutic use; D017963:Azithromycin / Q000494:pharmacology; D002443:Ceftriaxone / Q000494:pharmacology; D002511:Cephalosporins / Q000494:pharmacology; D002939:Ciprofloxacin / Q000494:pharmacology; D024901:Drug Resistance, Multiple, Bacterial; D006069:Gonorrhea / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology; D015438:Health Behavior; D006801:Humans; D008826:Microbial Sensitivity Tests; D009344:Neisseria gonorrhoeae / Q000187:drug effects* / Q000201:enzymology / Q000302:isolation & purification; D010403:Penicillin Resistance; D010405:Penicillinase / Q000096:biosynthesis; D010406:Penicillins / Q000494:pharmacology; D015995:Prevalence; D000198:Spectinomycin / Q000494:pharmacology; D013752:Tetracycline / Q000494:pharmacology; D013753:Tetracycline Resistance; D014300:Trinidad and Tobago / Q000453:epidemiology
chemical_list: D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D010406:Penicillins; D002939:Ciprofloxacin; D002443:Ceftriaxone; D017963:Azithromycin; D000198:Spectinomycin; D010405:Penicillinase; D013752:Tetracycline