Antibiotic susceptibility of Neisseria gonorrhoeae in Trinidad and Tobago

West Indian Med J. 1997 Dec;46(4):107-10.

Abstract

Treatment failures with standard doses of penicillin have been observed in the Sexually Transmitted Diseases (STD) clinics in Trinidad and Tobago. In the absence of an ongoing surveillance system, the antimicrobial susceptibility of 518 Neisseria gonorrhoeae strains was determined in order to guide treatment. 39 (7.6%) strains were resistant to penicillin, including 27 (5.2%) positive for beta-lactamase; that is penicillinase-producing Neisseria gonorrhoeae (PPNG). 51 (10%) strains were resistant to tetracycline, with 26 (5.0%) of these exhibiting high levels of resistance compatible with tetracycline resistant Neisseria gonorrhoeae (TRNG). Six strains showed evidence of having both PPNG and TRNG plasmids, and five strains showed chromosomally-mediated resistance to both penicillin and tetracycline. The overall resistance rate to penicillin and tetracycline was 17.7%. There was no resistance to spectinomycin, cefuroxime, ceftriaxone and norfloxacin. The resistance rates demonstrated in this study are sufficiently significant to preclude the use of penicillin and tetracycline in the STD clinics and to justify the use of newer antimicrobials. It is essential that resistance patterns be monitored by continued surveillance.

PIP: Neisseria gonorrhoeae from many areas of the world have developed resistance to a wide variety of antibiotics over the past 2 decades. The incidence of treatment failures with standard doses of penicillin observed in Trinidad and Tobago's sexually transmitted disease (STD) clinics suggests that such resistance also exists in Trinidad. 518 Neisseria gonorrhoeae strains were isolated from 1502 male and female patients attending the 7 STD clinics throughout Trinidad during May-October 1992, and tested to identify their antimicrobial susceptibility. 39 strains were resistant to penicillin, including 27 which were positive for beta-lactamase, indicating infection with penicillinase-producing Neisseria gonorrhoeae (PPNG). 51 strains were resistant to tetracycline, of which 26 exhibited high levels of resistance compatible with tetracycline-resistant Neisseria gonorrhoeae (TRNG). 6 strains showed evidence of having both PPNG and TRNG plasmids, and 5 strains showed chromosomally-mediated resistance to both penicillin and tetracycline. The overall resistance rate to penicillin and tetracycline was 17.7%, and there was resistance to neither spectinomycin, cefuroxime, ceftriaxone, nor norfloxacin. The resistance rates observed in this study are significant enough to warrant the cessation of penicillin and tetracycline use in STD clinics, and the use of newer antimicrobials. Neisseria gonorrhoeae resistance patterns demand ongoing monitoring.

MeSH terms

  • Female
  • Humans
  • Male
  • Neisseria gonorrhoeae / drug effects*
  • Neisseria gonorrhoeae / isolation & purification
  • Penicillin Resistance*
  • Sexually Transmitted Diseases / epidemiology
  • Sexually Transmitted Diseases / microbiology
  • Tetracycline Resistance*
  • Trinidad and Tobago / epidemiology