Emergence of ciprofloxacin resistant Neisseria gonorrhoeae in north India.
OBJECTIVE
Though quinolones have been recommended as a single dose treatment for uncomplicated gonorrhoea, there have been reports of treatment failure with fluoroquinolones. In this study we determined the antimicrobial susceptibility levels of consecutive isolates of Neisseria gonorrhoeae to examine the emergence of ciprofloxacin resistance N. gonorrhoeae.


METHODS
Minimum inhibitory concentration (MIC) of ciprofloxacin and other drugs (penicillin, tetracycline, ciprofloxacin and ceftriaxone) was determined by agar dilution method. MIC was interpreted according to the NCCLS guidelines. beta lactamase production was detected by iodometric method and chromogenic cephalosporin method using nitrocefin disc.


RESULTS
A total of 45 consecutive isolates of N. gonorrhoeae were obtained from patients with suspected acute gonococcal uretheritis. Of the 45 isolates, 35 (77.7%) were resistant to ciprofloxacin, 16 (35.5%) showed MIC value greater than 8 microg/ml. All isolates were sensitive to ceftriaxone while 21 isolates (46.6%) were resistant to penicillin and 23 (51%) to tetracycline. Ten isolates (22%) were found to be beta-lactamase producers.


CONCLUSIONS
Ciprofloxacin resistant N. gonorrhoeae is on the rise in and around Chandigarh (north India). Thus, periodic surveillance of susceptibility levels of N. gonorrhoeae is essential to prevent the dissemination of drug resistant strains in the community.
Sethi
Sunil
S
Departments of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India. sunilsethi10@hotmail.com
Sharma
Dharmendra
D
Mehta
S D
SD
Singh
Bhupinder
B
Smriti
Manu
M
Kumar
Bhushan
B
Sharma
Meera
M
D000900:Anti-Bacterial Agents / Q000494:pharmacology; D002939:Ciprofloxacin / Q000494:pharmacology*; D024881:Drug Resistance, Bacterial; D006069:Gonorrhea / Q000188:drug therapy / Q000382:microbiology; D006801:Humans; D007194:India; D008297:Male; D008826:Microbial Sensitivity Tests; D009344:Neisseria gonorrhoeae / Q000187:drug effects* / Q000302:isolation & purification; D014526:Urethritis / Q000188:drug therapy / Q000382:microbiology
D000900:Anti-Bacterial Agents; D002939:Ciprofloxacin