title: Surveillance of antimicrobial susceptibilities of Neisseria gonorrhoeae in Nanning, China, 2000 to 2012.
abstract: OBJECTIVE
  To monitor the frequency of antibiotic resistance of Neisseria gonorrhoeae (NG) in Nanning, China, between 2000 and 2012.
  
  
  METHODS
  The production of β-lactamase by NG isolates was determined using the paper acidometric testing method. Antimicrobial susceptibility testing was performed for tetracycline, ciprofloxacin, spectinomycin, and ceftriaxone using the agar dilution method. The χ(2) test, t test, and univariate and multivariate analyses were used to analyze the statistical difference of the results.
  
  
  RESULTS
  A total of 923 NG isolates were collected in Nanning between 2000 and 2012. Among these, 131 (14.2%) were penicillinase-producing NG, 520 (56.3%) isolates were tetracycline-resistant NG, and 857 (92.9%) isolates were ciprofloxacin-resistant strains. One spectinomycin-resistant strain was identified in 2000. There were 304 (32.9%) isolates with decreased susceptibility to ceftriaxone; the proportion of such isolates increased from 22.8% in 2000 to 2002 to 48.9% in 2006 to 2008 (P < 0.001), followed by a fall to 32.2% in 2009 to 2012 (P = 0.001). Patients' age of 16 to 25 years and isolate collection period of 2008 to 2012 (except 2011) were demonstrated to be risk factors for infection with isolates with decreased susceptibility to ceftriaxone.
  
  
  CONCLUSIONS
  Antimicrobial susceptibility of NG isolates obtained from patients in Nanning from 2000 to 2012 was characterized by high occurrence of penicillinase-producing NG, tetracycline-resistant NG, and ciprofloxacin-resistant strains. Spectinomycin and ceftriaxone can be considered drugs of choice for empirical treatment of NG infection in Nanning. Moreover, we recommend a combination of 500 mg or higher dose of intramuscular ceftriaxone and 1 g oral azithromycin be used for the treatment of NG infection in Nanning and possibly in China.
authors.affiliation: From the *Institute of Dermatology, Guangxi Autonomous Region, Nanning, China; †Reference STD Lab, National Center for STD Control, Chinese CDC, and Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, and Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Nanjing, Jiangsu Province, China; and ‡The First Affiliated Hospital of Guangxi Medical University, Institute of Dermatology, Nanning, China.
authors.forename: Bang-yong
authors.initials: BY
authors.lastname: Zhu
authors.forename: Rui-xing
authors.initials: RX
authors.lastname: Yu
authors.forename: Yueping
authors.initials: Y
authors.lastname: Yin
authors.forename: Xiangsheng
authors.initials: X
authors.lastname: Chen
authors.forename: Wei
authors.initials: W
authors.lastname: Li
authors.forename: Xiu-qin
authors.initials: XQ
authors.lastname: Dai
authors.forename: Ming
authors.initials: M
authors.lastname: Liang
authors.forename: Quan
authors.initials: Q
authors.lastname: Gan
authors.forename: Yan-jie
authors.initials: YJ
authors.lastname: Huang
authors.forename: Jiang-ping
authors.initials: JP
authors.lastname: Wei
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D017963:Azithromycin / Q000627:therapeutic use; D002443:Ceftriaxone / Q000627:therapeutic use; D002681:China / Q000453:epidemiology; D002939:Ciprofloxacin / Q000627:therapeutic use; D024881:Drug Resistance, Bacterial / Q000235:genetics / Q000276:immunology*; D005260:Female; D006069:Gonorrhea / Q000453:epidemiology* / Q000276:immunology; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009344:Neisseria gonorrhoeae / Q000187:drug effects* / Q000302:isolation & purification; D018571:Sentinel Surveillance; D000198:Spectinomycin / Q000627:therapeutic use; D013752:Tetracycline / Q000627:therapeutic use; D001618:beta-Lactamases / Q000235:genetics / Q000276:immunology
chemical_list: D000890:Anti-Infective Agents; D002939:Ciprofloxacin; D002443:Ceftriaxone; D017963:Azithromycin; D000198:Spectinomycin; D001618:beta-Lactamases; D013752:Tetracycline