Fluoroquinolone Resistance Among Neisseria gonorrhoeae Isolates in Hawaii, 1990–2000

Abstract

Infections with ciprofloxacin-resistant N. gonorrhoeae are increasing and evolving in Hawaii.

What Management Is There for Gonorrhea in the Postquinolone Era?

“…The pattern of spread of QRNG noted in France is also similar to that described previously in those parts of the United States 3 and Australia 2,4 on the Pacific rim and close to countries in South and East Asia where QRNG now represents 90% or more of all isolates. 5 The appearance of QRNG in this region was documented a decade ago, 6 and this focus has provided a reservoir for global spread of QRNG.…”

Prevalence of and Associated Risk Factors for Fluoroquinolone-Resistant Neisseria gonorrhoeae in California, 2000-2003

“…When the prevalence of QRNG began to increase in Hawaii in 1999, most case patients reported foreign travel [9]. As the epidemic evolved, travel history was no longer a significant risk factor, probably reflecting endemic transmission of QRNG in the population [30,40,41]. A similar evolution occurred in London, England, between 1997 and 2000 [42].…”

Antimicrobial Resistance in Neisseria gonorrhoeae in the 21st Century: Past, Evolution, and Future

“…Ciprofloxacin-resistant gonococcal strains were subsequently rapidly exported internationally or emerged independently (121)(122)(123). In regard to the United States, in 2000, fluoroquinoloneresistant strains initially imported from Asia were prevalent in Hawaii (124), and subsequently, these strains spread first to the West Coast and then to the rest of the United States, predominantly among MSM (125). In 2007, the fluoroquinolones were abandoned from the CDC-recommended treatment regimens for gonorrhea, with no exceptions (126).…”