Antimicrobial resistance in Neisseria gonorrhoeae in the northeast Romania

Abstract number: p1067

Badescu  A., Enache  A., Petrescu  Z., Buiuc  D.

Objectives: 

The emergence of gonococcal isolates with reduced susceptibility or resistance to antimicrobial agents is a significant concern in the whole world. This study is aimed to characterize the current antimicrobial susceptibility/resistance patterns of N. gonorrhoeae isolates from North-East of Romania.

Methods: 

From September 2004 to October 2005, a total of 40 isolates of N. gonorrhoeae were collected from 37 male patients with urethritis and 3 female patients with cervico-vaginitis attending the Sexually Transmitted Diseases Clinic in Iasi. Specimens from each patient were inoculated directly onto Thayer-Martin selective agar and incubated for 24 to 48 h at 35°C in a 5% CO2 atmosphere. Identification of suspected colonies was based upon the presence of gram-negative, oxidase-positive, superoxol-positive diplococci with typical enzyme patterns. The isolates were also tested for betalactamase production. The antimicrobial agents tested were penicillin, tetracycline, ciprofloxacin, cefixime, ceftriaxone and spectinomycin. Susceptibility testing were performed by agar diffusion method with a GC agar base containing1% Vitox, according to CLSI recommendations.

Results: 

Of the 40 tested isolates 31(77.5%) were resistant to penicillin by betalactamase production, all the betalactamase negative strains demonstrated intermediate resistance. Tetracycline resistance was observed in 32 (80%) of isolates and 5 (12.5%) were intermediate resistant. 52.5% of the strains were resistant to ciprofloxacin with a further 27.5% showing intermediate resistance. In our study 13 strains (32.5%) demonstrated triple resistance (penicillin, tetracycline, ciprofloxacin). No isolate was found to be resistant to ceftriaxone, cefixime or spectinomycin.

Conclusions: 

Penicillin, tetracycline, and ciprofloxacin can no longer be recommended for the treatment of gonorrhea in our area; ceftriaxone, cefixime and spectinomycin should be considered the antimicrobial of choice. Since 32.5% of tested gonococcal isolates were resistant to three antibiotics, the monitoring of the resistance to antimicrobial agents in N. gonorrhoeae must be established in Romania on a permanent basis in order to adjust standardized treatment regimens.