title: Antimicrobial susceptibilities of Neisseria gonorrhoeae strains isolated in Java, Indonesia.
abstract: BACKGROUND
  Despite the rapid spread of antibiotic resistance in gonococci all over Southeast Asia, there is only limited surveillance for antibiotic susceptibility in Indonesia.
  
  
  OBJECTIVE
  This study was undertaken to determine the frequency and diversity of antimicrobial resistance in gonococcal isolates from cohorts of female commercial sex workers in Bandung and Jakarta, Indonesia, and to characterize the Tet M plasmid among the tetracycline-resistant strains N gonorrhoeae.
  
  
  METHODS
  The antimicrobial susceptibility of 267 strains (85 strains from Bandung and 182 from Jakarta) to penicillin, spectinomycin, tetracycline, ciprofloxacin, cefotaxime, thiamphenicol, kanamycin, azithromycin, and trimethoprim-sulfamethoxazole (TMP-SMZ) was determined by agar dilution. Typing of the Tet M plasmid in tetracycline-resistant isolates was performed by PCR.
  
  
  RESULTS
  Prevalence of penicillin and tetracycline resistance was extremely high: 60.0% of the isolates from Bandung and 70.9% of the isolates from Jakarta were resistant to penicillin. Of these, 60.0% and 62.1%, respectively, were penicillinase-producing N gonorrhoeae (PPNG). All the isolates from Bandung and 98.4% from Jakarta were resistant to tetracycline. All tetracycline-resistant isolates from Bandung and 97.8% from Jakarta carried a PCR fragment characteristic of the "Dutch" type Tet M plasmid. One isolate from Jakarta showed chromosomal resistance to tetracycline (0.6%). Chromosomal resistance to thiamphenicol (MIC, >/=2.0 microg/ml) was significantly higher in Jakarta than in Bandung (P < 0.05). All gonococcal isolates were susceptible to kanamycin, spectinomycin, cefotaxime, ciprofloxacin, and azithromycin.
  
  
  CONCLUSIONS
  Spectinomycin, fluoroquinolones, and azithromycin are still useful primary drugs for treatment of gonococcal infections in Indonesia. Continued surveillance of antimicrobial susceptibility should be part of gonorrhea control in Indonesia.
authors.affiliation: Department of Medical Microbiology, University Hospital Antwerp, UIA, Antwerp, Belgium. Greet.Ieven@uza.be
authors.forename: Margareta
authors.initials: M
authors.lastname: Ieven
authors.forename: Marleen
authors.initials: M
authors.lastname: Van Looveren
authors.forename: Sunarjati
authors.initials: S
authors.lastname: Sudigdoadi
authors.forename: Yeva
authors.initials: Y
authors.lastname: Rosana
authors.forename: Wendy
authors.initials: W
authors.lastname: Goossens
authors.forename: Christine
authors.initials: C
authors.lastname: Lammens
authors.forename: André
authors.initials: A
authors.lastname: Meheus
authors.forename: Hernan
authors.initials: H
authors.lastname: Goossens
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D015331:Cohort Studies; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D006069:Gonorrhea / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology*; D006801:Humans; D007214:Indonesia / Q000453:epidemiology; D008826:Microbial Sensitivity Tests; D009344:Neisseria gonorrhoeae / Q000187:drug effects* / Q000302:isolation & purification; D010403:Penicillin Resistance; D010406:Penicillins / Q000494:pharmacology; D015995:Prevalence; D011477:Sex Work; D013752:Tetracycline / Q000494:pharmacology; D013753:Tetracycline Resistance
chemical_list: D000900:Anti-Bacterial Agents; D010406:Penicillins; D013752:Tetracycline