Alarming increase in ciprofloxacin- and penicillin-resistant Neisseria gonorrhoeae isolates in New Delhi, India

Safdarjang Hospital, New Dilli, NCT, India
Sex Transm Dis (Impact Factor: 2.75). 07/2003; 30(6):523-5. DOI: 10.1097/00007435-200306000-00010
Source: PubMed

ABSTRACT Resistance of ciprofloxacin has been reported in several regions of the world, including India. In India, ciprofloxacin is still being used as single-dose treatment for gonorrhea.
The aim of the study was to determine the antimicrobial susceptibility of Neisseria gonorrhoeae isolates from patients with acute gonococcal urethritis in New Delhi.
By means of disc diffusion, we determined the susceptibility profiles of N gonorrhoeae isolates, determined the MICs of ciprofloxacin, penicillin, and ceftriaxone, and compared our data with previous findings.
On the basis of MIC values, 35.3% and 52.9% of strains were found to be resistant and less sensitive, respectively, to penicillin; 67.3% and 28.2% strains were observed to be resistant and less sensitive, respectively, to ciprofloxacin. Only one isolate (5.9%) was found to be less sensitive to ceftriaxone.
The significant increase in ciprofloxacin resistance in the current study indicates that resistance has developed under selective antibiotic pressure.

1 Follower
  • [Show abstract] [Hide abstract]
    ABSTRACT: Gonorrhea is a major sexually transmitted disease worldwide and for its control, effective treatment is essential. However as more strains of Neisseria gonorrhoeae continuously develop resistance to several drugs, this strategy obliges scientists to discover newer effective drugs. To ascertain whether crude leaf and root extracts of Cassia alata (Caesalpiniaceae) have antimicrobial activity against clinically resistant Neisseria gonorrhoeae bacteria. To determine and compare the MICs of their ether and methanol extracts. Ether and methanol extracts were prepared from the plant parts. 12-375mg/ml of serially diluted ether extracts in DMSO and methanol extracts in water were tested using agar-well diffusion method against Neisseria gonorrhea clinical isolate cultured on MTM agar. MICs were determined from corresponding concentration-response curves. Ceftriaxone was used as positive control, whereas DMSO and water as negative controls. All the crude extracts showed concentration-dependent Neisseria gonorrhea inhibition. Ether extracts for both leaves and roots gave lower MICs compared to those of methanol. Ether root extract showed the highest potency. Both the leaf and the root of Cassia alata plant have activity against clinically resistant Neisseria gonorrhoeae; the root having the higher activity. Lipophilic solvent, ether, give more potent antigonorrhoeal extracts. As expected Cassia alata plant in Central Uganda also has antibacterial activity.
    African health sciences 12/2014; 14(4):840-8. DOI:10.4314/ahs.v14i4.11 · 0.66 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Antimicrobial resistance in Neisseria gonorrhoeae jeopardizes public health and continues to spread out to currently recommended and older antimicrobial agents. Antimicrobial resistance (AMR) surveillance provides essential clues toward the modification of treatment guidelines. The aim of the study was to determine gonococcal AMR profile and trends between 2007 and 2012 and to evaluate any change in AMR profile in comparison with published trends in 2002 to 2006. Antimicrobial susceptibility testing of 261 N. gonorrhoeae isolates from consecutive patients between 2007 and 2012 was determined for penicillin, tetracycline, ciprofloxacin, spectinomycin, extended-spectrum cephalosporins (ceftriaxone, cefixime, cefpodoxime) and azithromycin by the disk diffusion technique and the Etest method. P value was determined using χ test for comparisons of trends between the 2 periods. In comparison of AMR trends between 2002-2006 and 2007-2012, penicillinase-producing N. gonorrhoeae, tetracycline-resistant N. gonorrhoeae, and ciprofloxacin-resistant strains increased significantly from 21.2% to 47.9% (P < 0.0001), 13.6% to 25.3% (P = 0.0002), and 78% to 89.7% (P = 0.0001), respectively. An insignificant increase from 2.4% to 4.2% (P > 0.05) in decreased susceptibility to ceftriaxone and 0.8% to 1.5% (P > 0.05) for azithromycin resistance was observed. All isolates were susceptible to spectinomycin over both the periods, except for one isolate in 2002. The study highlights that there is a continuous increase in resistance to previously recommended antibiotics despite their disuse for treatment. The increase in number of strains with decreased susceptibility to extended-spectrum cephalosporins and azithromycin resistance, currently recommended for management of gonorrhea, is of serious concern. These trends should be monitored continuously to change antibiotic policy.
    Sex Transm Dis 04/2015; 42(4):218-222. DOI:10.1097/OLQ.0000000000000261 · 2.75 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: In the study, the ciprofloxacin resistance rate was 100%. High-level ciprofloxacin resistance rate was 63.55%. Sixteen different mutation patterns involved in the formation of ciprofloxacin resistance were identified. The most prevalent were patterns P7 (25.2%), P8 (15.0%), P9 (11.2%), P1 (10.3%), and P5 (10.3%). All of the 107 NG isolates analyzed for mutations in the study have demonstrated a change of Ser-91 → Phe in the gyrA gene, and all except one have demonstrated a change in position 95 of the amino acid sequence. All of the 68 high-level QRNG isolates had double mutations in gyrA gene combined with a single or two mutations in parC gene. It is most important that a new mutation site of Ile-97 → Met in gyrA and a new mutation of Leu-106 → Ile in parC were found in the study, both leading to high-level ciprofloxacin resistance (MIC values, 8 μg/mL, 32 μg/mL, respectively). Therefore, we confim that gyrA mutations are necessary for the fluoroquinolone resistance phenotype and parC mutations are correlated intimately with high-level fluoroquinolone resistance. In China fluoroquinolone resistance in Neisseria gonorrhoeae strains is very serious and the new mutation sites in the fluoroquinolone resistance-determining regions emerge more and more quickly. Hence, in China fluoroquinolones, which are used to treat gonorrhoea presently, should be substituted by a new antibiotics.
    Brazilian Journal of Microbiology 05/2013; 44(1):273-6. DOI:10.1590/S1517-83822013005000020 · 0.45 Impact Factor