title: Gonococcal resistance: evolving from penicillin, tetracycline to the quinolones in South Africa -- implications for treatment guidelines.
abstract: Resistant Neisseria gonorrhoeae has been evolving. This study assessed the antimicrobial susceptibility profile of isolates in the Pretoria region, South Africa. Isolates of N. gonorrhoeae from men with urethritis were tested for susceptibility to eight antimicrobial agents by disc diffusion, Etest and agar dilution methods. Chromosomal resistance to penicillin was found in 16% of isolates, 16% showed plasmid-mediated resistance and decreased susceptibility was seen in 73% of isolates. For the first time, there is evidence of high-level tetracycline resistance (36%). Ciprofloxacin resistance emerged at 7%. All isolates remained susceptible to ceftriaxone. In view of these findings of the emergence of quinolone-resistant N. gonorrhoeae, national treatment guidelines for syndromic management of sexually transmitted infections need to be urgently reviewed. The injectable preparation, ceftriaxone has to be considered as a first-line agent for the management of gonococcal infections. Overall, the gonococcal isolates in the Pretoria region remain susceptible to ceftriaxone, cefoxitin, cefpodoxime and spectinomycin.
authors.affiliation: Department of Microbiological Pathology, University of Limpopo Medunsa Campus, Ga-Rankuwa, Medunsa, South Africa.
authors.forename: Mari
authors.initials: M
authors.lastname: De Jongh
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Dangor
authors.forename: Anvir
authors.initials: A
authors.lastname: Adam
authors.forename: Anwar A
authors.initials: AA
authors.lastname: Hoosen
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use; D002511:Cephalosporins / Q000494:pharmacology; D024881:Drug Resistance, Bacterial; D006069:Gonorrhea / Q000188:drug therapy / Q000382:microbiology*; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D009344:Neisseria gonorrhoeae / Q000187:drug effects* / Q000302:isolation & purification; D010403:Penicillin Resistance / Q000235:genetics; D015363:Quinolones / Q000494:pharmacology* / Q000627:therapeutic use; D013019:South Africa; D000198:Spectinomycin / Q000494:pharmacology; D013752:Tetracycline / Q000494:pharmacology* / Q000627:therapeutic use; D013753:Tetracycline Resistance; D014526:Urethritis / Q000382:microbiology; D047090:beta-Lactams / Q000494:pharmacology* / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D015363:Quinolones; D047090:beta-Lactams; D000198:Spectinomycin; D013752:Tetracycline