Multidrug‐ResistantNeisseria gonorrhoeaewith Decreased Susceptibility to Cefixime—Hawaii, 2001

Abstract

We report 4 urogenital Neisseria gonorrhoeae isolates recovered from 3 patients that demonstrated resistance to penicillin, tetracycline, and ciprofloxacin and reduced susceptibility to cefixime. This report of the first 3 patients in the United States identified with this multidrug-resistant strain may portend an emerging problem for clinicians and public health officials.

Strain Typing and Antimicrobial Resistance of Fluoroquinolone-Resistant Neisseria gonorrhoeae Causing a California Infection Outbreak

“…The failure of azithromycin to eradicate Neisseria gonorrhoeae has been reported with 1-g single doses, and the isolates from those cases demonstrated MICs of 0.125 to 0.25 g/ml, although that study used methods different from those used by reference laboratories in the United States (27). Although specific criteria have not been defined by the CLSI for azithromycin resistance in N. gonorrhoeae (11), isolates recovered in Kansas City, MO, in 1999 and 2000 had MICs as high as 4.0 g/ml, but again, standard methods were not used (30).…”

“…The manufacture of cefixime in tablet form was discontinued by the original manufacturer for many years in the United States, but it is now available again and can be used as first-line therapy when it is so indicated (4). Despite this gain, antimicrobial resistance in N. gonorrhoeae remains a serious problem that requires a comprehensive approach to prevention because of the potential for multidrug resistance (33), as demonstrated by the independent identification of N. gonorrhoeae strains in the United States with MICs that support decreased susceptibility to cefixime or the potential for treatment failure with suboptimal doses of azithromycin, the alternative oral agent for the treatment of gonorrhea (17,30,31). Cefixime and ceftriaxone still remain dependable first-line treatments because no failure of therapy with these agents for N. gonorrhoeae infections has been reported in the United States, although isolates with decreased cefixime susceptibility were found in Hawaii (30).…”

A Study Of The Antimicrobial Susceptibility Pattern Of Neisseria Gonorrhoeae

“…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]. In the present study also resistant and less susceptible strains to cefixime were noted which is a cause of concern.…”

Modern aspects of epidemiological surveillance of gonococcal infection spread

“…Первые описания штаммов N. gonorrhoeae со сниженной чувствительностью к цефалоспоринам III поколения относятся к 2001-2003 г. Рост рези-стентности N. gonorrhoeae к цефалоспоринам III по-коления был первоначально зарегистрирован на Га-вайях, в Японии, Канаде и Швеции [57][58][59][60].…”