title: Changing trends of antimicrobial susceptibility patterns of Neisseria gonorrhoeae in India and the emergence of ceftriaxone less susceptible N. gonorrhoeae strains.
abstract: OBJECTIVE
  To monitor the trend of antimicrobial susceptibility of Neisseria gonorrhoeae isolates from 2002 to 2006 in New Delhi, India under the Gonococcal Antimicrobial Susceptibility Programme and to document the emergence of any new antimicrobial resistance.
  
  
  METHODS
  Antimicrobial susceptibility of 382 N. gonorrhoeae isolates from clinical cases in males and females to penicillin, tetracycline, ciprofloxacin, spectinomycin and ceftriaxone was determined by disc diffusion technique, using WHO reference strains as controls and WHO interpretative criteria. MICs were determined using Etests.
  
  
  RESULTS
  A significant increasing trend of penicillin and ciprofloxacin resistance up to 2003 and 2004, respectively, and subsequent decrease in resistant strains with a concomitant increase in less susceptible strains, was observed. Tetracycline-resistant N. gonorrhoeae increased significantly from 6.7% in 2002 to 22.9% in 2005. Only one isolate was resistant to spectinomycin and nine isolates were less susceptible to ceftriaxone, during this 5 year period. A substantial proportion (23.3%) of strains were multiresistant.
  
  
  CONCLUSIONS
  Emergence of ceftriaxone less susceptible N. gonorrhoeae isolates is a cause for concern, although treatment failure was not observed. An active, continuous and comprehensive programme for monitoring and surveillance of antimicrobial resistance needs to be established in many laboratories, and a search for new effective agents needs to be initiated to respond to the emergence of resistant isolates.
authors.affiliation: Regional STD Teaching Training and Research Centre, Vardhman Mahavir Medical College and Safdarjang Hospital, New Delhi, India. manjubala_2@hotmail.com
authors.forename: Manju
authors.initials: M
authors.lastname: Bala
authors.forename: Krishna
authors.initials: K
authors.lastname: Ray
authors.forename: S M
authors.initials: SM
authors.lastname: Gupta
authors.forename: Sumathi
authors.initials: S
authors.lastname: Muralidhar
authors.forename: R K
authors.initials: RK
authors.lastname: Jain
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D002443:Ceftriaxone / Q000494:pharmacology*; D004352:Drug Resistance, Microbial; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D006069:Gonorrhea / Q000453:epidemiology / Q000382:microbiology*; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008826:Microbial Sensitivity Tests; D009344:Neisseria gonorrhoeae / Q000187:drug effects*; D011785:Quality Assurance, Health Care; D013753:Tetracycline Resistance; D001618:beta-Lactamases / Q000378:metabolism
chemical_list: D000900:Anti-Bacterial Agents; D002443:Ceftriaxone; D001618:beta-Lactamases