Changing trends of antimicrobial susceptibility patterns of Neisseria gonorrhoeae in India and the emergence of ceftriaxone less susceptible N. gonorrhoeae strains

Abstract

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.

A Study Of The Antimicrobial Susceptibility Pattern Of Neisseria Gonorrhoeae

“…There were more of less susceptible strains than resistant strains for penicillin, tetracycline and ciprofloxacin in the present study similar to a study conducted by Manju bala et al in Delhi [8]. This may reflect the loss of selective pressure from the disuse of these antibiotics as treatment for gonorrhoea.…”

“…In the present study, PPNG were 30% which compared well with other studies as shown in Table 2 except for a study from Indonesia which reported 79%. In WHO Western Pacific Region (WPR), the prevalence of PPNG varied from 1% to 90% [8]. PPNG isolates from Asia are proline auxotrophs and carry a 4.4 MDa plasmid [9].…”

“…Presently, the recommended first-line treatments for gonorrhea in most countries include antibiotics such as cefixime, ceftriaxone, spectinomycin, and in some cases azithromycin or ciprofloxacin. However, resistance to fluoroquinolones and azithromycin is rapidly increasing [8,10]. The use of the quinolone group of antibiotics for the treatment of gonorrhoea has been discontinued in India for quite some time because of reported high levels of resistance.…”

“…QRNG is also widely distributed in other WHO SEAR and WPR countries [12, 13, 14, 15, and 16]. Recently and most disquieting, the emergence of N. gonorrhoeae isolates with reduced susceptibility or resistance in vitro to broad-spectrum cephalosporins such as cefixime [7,17,18,19,20,21,22] and ceftriaxone [8] have been reported. In occasional cases, treatment failures when using cefixime have been reported [22].…”

First reported case of cefuroxime resistant Neisseria gonorrhoeae in Sri Lanka

“…Thereafter various other groups of antibiotics were used including tetracyclines, spectinomycin, fluoroquinolones and cephalosporins but concerns have been raised as the emergence of resistance to some of these were reported in several countries. [3] In Sri Lanka gonorrhea treatment started with penicillin in 1960s. Even with some resistance, penicillin was the drug of choice till early 1990s when the resistant cases were treated with tetracycline, kanamycin, spectinomycin, erythromycin etc.…”