Antimicrobial Susceptibility Patterns in Neisseria gonorrhoeae Isolated from South African Pregnant Women

Abstract

Background. Neisseria gonorrhoeae, a sexually transmitted infection, is associated with adverse pregnancy and neonatal outcomes. Emerging resistance towards various antibiotics has been observed globally. However, there is a lack of data on antimicrobial susceptibility patterns in N. gonorrhoeae isolated from pregnant women in our setting. This study fills in this gap in the literature. Methods. The study population included pregnant women, recruited from the antenatal clinic of the King Edward VIII hospital (KEH) in Durban. Endocervical swabs were obtained from 307 women. The swab was placed in Amies Charcoal media for culture assessments. Pure isolates of N. gonorrhoeae were subjected to antimicrobial susceptibility testing using the Etest™ method. The MIC values were assessed in accordance with the European Committee on Antimicrobial Susceptibility Testing (EUCAST, 2019) breakpoints. Results. The prevalence of N. gonorrhoeae by culture was 1.9%. High MIC values to penicillin G (12-64 mg/L) indicating a resistant phenotype were observed for all isolates tested, with 50% of the isolates displaying complete resistance. Isolates with intermediate (1 mg/L) and resistance (1.9-32 mg/L) profiles to tetracycline were observed. Resistance to ciprofloxacin (1.16-3 mg/L) was also observed. Isolates displayed either dual or triple resistance to penicillin G, tetracycline, or ciprofloxacin. All isolates showed susceptibility to spectinomycin (>64 mg/L), azithromycin (1 mg/L), ceftriaxone (>0.125 mg/L), and cefixime (>0.125 mg/L). Conclusion. Despite lack of resistance to ceftriaxone and azithromycin, continuous surveillance for emerging patterns of resistance to these antibiotics is needed since they form part of the treatment guidelines.

Neisseria gonorrhoeae antimicrobial resistance patterns and associated risk factors in women of childbearing potential in northwestern Ethiopia

“…This is comparable to studies conducted in Mekelle, Ethiopia (10.04%) [ 30 ], in Italy (7.4%) [ 31 ]; Iran (7.2%) [ 32 ]; South Africa (6.8%) [ 33 ]; Swaziland (6.0%) [ 12 ]; Jimma, Ethiopia (9.4%) [ 29 ], and Gambella, Ethiopia (5.0%) [ 34 ]. However, it was higher than studies reported from Ethiopia: Hawassa (3.3%) [ 35 ]; Bahir dar (4.7%) [ 36 ]; and Hawassa again (4.3%) [ 37 ]; (1.6%) in Kenya [ 38 ]; (1.8%) in Gambia [ 39 ]; (1.9%) in South Africa [ 40 ]; and 1.0% in Brazil [ 41 ]. On the other hand, our result was lower than the studies from Addis Ababa, Ethiopia (11.4%) [ 42 ]; and Ghana (28.3%) [ 43 ].…”

The Impact of Microorganisms in Pregnancy

“…In Washington State in 2014, the incidence of gonorrhea infection in women ages 15-24 was 273 cases per 100,000 women and this has been rising in the past five year [7] Neisseria gonorrhoeae is A global STI surveillance in 2018 was conducted by the World Health Organization (WHO) and revealed an estimated 87 million new gonorrhoea infections globally during 2016, with an incidence of 20 cases per 1000 population in women . A study conducted exclusively on pregnant women reported a prevalence of 1.3% for N. gonorrhoeae [8] One of the most important reasons for infertility is tubular factor related to untreated sexually transmitted diseases that one of these causative agents is Neisseria gonorrhea [9]. N.gonorrhea is major causes of maternal and neonatal morbidity and mortality in developing countries [10].…”