This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrowReprints and Permissions
Right arrow Copyright Information
Right arrow Books from ASM Press
Right arrow MicrobeWorld
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Ison, C. A.
Right arrow Articles by Claydon, E.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Ison, C. A.
Right arrow Articles by Claydon, E.

 Previous Article  |  Next Article 

Antimicrobial Agents and Chemotherapy, November 1998, p. 2919-2922, Vol. 42, No. 11
0066-4804/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.

Drift in Susceptibility of Neisseria gonorrhoeae to Ciprofloxacin and Emergence of Therapeutic Failure

Catherine A. Ison,1,* Patricia J. Woodford,1 Helen Madders,1,dagger and Elizabeth Claydon2

Department of Infectious Diseases and Microbiology, Imperial College School of Medicine, St. Mary's Campus,1 and The Jefferiss Wing, St. Mary's Hospital,2 London, United Kingdom

Received 11 May 1998/Returned for modification 24 June 1998/Accepted 26 August 1998

Ciprofloxacin, 500 mg, was introduced as the first-line therapy for gonorrhea at St. Mary's Hospital, London, in 1989, when a surveillance program was initiated to detect the emergence of resistance. Isolates of Neisseria gonorrhoeae from consecutive patients attending the Jefferiss Wing, Genitourinary Medicine Clinic at St. Mary's Hospital, between 1989 and 1997 have been tested for susceptibility to ciprofloxacin by using an agar dilution breakpoint technique. Isolates considered potentially resistant (MIC, >0.12 µg/ml) were further characterized by determination of the MICs of ciprofloxacin, nalidixic acid, and penicillin, auxotyped and serotyped, and screened for mutations in the DNA gyrase gene, gyrA, and the topoisomerase IV gene, parC. A total of 4,875 isolates were tested. While the majority of isolates were highly susceptible (MIC, <= 0.008 µg of ciprofloxacin/ml), there was a drift toward reduced susceptibility in N. gonorrhoeae isolated between 1993 and 1996 (P < 0.001). In 1997 this drift was reduced but remained above pre-1993 levels. Isolates from 18 patients were classed as potentially resistant (MIC, >0.12 µg/ml); all of these belonged to serogroup B, and NR/IB-1 was the most common auxotype/serovar class. The infections in 14 of the 18 patients were known to be acquired abroad, and 5 were known to result in therapeutic failure. The surveillance program has established that ciprofloxacin is still a highly effective antibiotic against N. gonorrhoeae in this population. However, it has identified a drift in susceptibility which may have resulted from increased usage of ciprofloxacin. High-level resistance has now emerged, although treatment failure is still uncommon.

* Corresponding author. Mailing address: Medical Microbiology, ICSM, St. Mary's Campus, Norfolk Place, Paddington, London W2 1PG, United Kingdom. Phone: 44-171-594-3965. Fax: 44-171-262-6299. E-mail: c.ison{at}ic.ac.uk.

dagger Present address: Immunobiology Unit, Institute of Child Health, London WC1N 1EH, United Kingdom.

Antimicrobial Agents and Chemotherapy, November 1998, p. 2919-2922, Vol. 42, No. 11
0066-4804/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.


This article has been cited by other articles:

  • Palmer, H M, Young, H, Graham, C, Dave, J (2008). Prediction of antibiotic resistance using Neisseria gonorrhoeae multi-antigen sequence typing. Sex. Transm. Infect. 84: 280-284 [Abstract] [Full Text]  
  • Ragunathan, P. L., Ison, C., Livermore, D. M. (2005). Nalidixic acid-susceptible, ciprofloxacin-resistant Neisseria gonorrhoeae strain in the UK. J Antimicrob Chemother 56: 437-437 [Full Text]  
  • Rogstad, K E (2004). Sex, sun, sea, and STIs: sexually transmitted infections acquired on holiday. BMJ 329: 214-217 [Full Text]  
  • Chaudhry, U, Ray, K, Bala, M, Saluja, D (2002). Mutation patterns in gyrA and parC genes of ciprofloxacin resistant isolates of Neisseria gonorrhoeae from India. Sex. Transm. Infect. 78: 440-444 [Abstract] [Full Text]  
  • Dan, M., Poch, F., Sheinberg, B. (2002). High Prevalence of High-Level Ciprofloxacin Resistance in Neisseria gonorrhoeae in Tel Aviv, Israel: Correlation with Response to Therapy. Antimicrob. Agents Chemother. 46: 1671-1673 [Abstract] [Full Text]  
  • Ison, C A, Martin, I M C (2002). Gonorrhoea in London: usefulness of first line therapies. Sex. Transm. Infect. 78: 106-109 [Abstract] [Full Text]  
  • Su, X., Lind, I. (2001). Molecular Basis of High-Level Ciprofloxacin Resistance in Neisseria gonorrhoeae Strains Isolated in Denmark from 1995 to 1998. Antimicrob. Agents Chemother. 45: 117-123 [Abstract] [Full Text]  
  • Mavroidi, A., Tzouvelekis, L. S., Tassios, P. T., Flemetakis, A., Daniilidou, M., Tzelepi, E. (2000). Characterization of Neisseria gonorrhoeae Strains with Decreased Susceptibility to Fluoroquinolones Isolated in Greece from 1996 to 1999. J. Clin. Microbiol. 38: 3489-3491 [Abstract] [Full Text]  
  • Walker, E. S., Neal, C. L., Laffan, E., Kalbfleisch, J. H., Berk, S. L., Levy, F. (2000). Long-term trends in susceptibility of Moraxella catarrhalis: a population analysis. J Antimicrob Chemother 45: 175-182 [Abstract] [Full Text]  


Copyright © 2009 by the American Society for Microbiology.   For an alternate route to Journals.ASM.org, visit: http://intl-journals.asm.org | More Info»