Antibiotic susceptibility of Neisseriagonorrhoeae in Arkhangelsk, Russia
- Veronica Vorobieva1,
- Natalia Firsova3,
- Tatiana Ababkova3,
- Ivan Leniv3,
- Bjørg C Haldorsen2,
- Magnus Unemo4,
- Vegard Skogen5
- 1Department of Microbiology and Virology, University of Tromsø, Tromsø, Norway
- 2Reference Centre for Detection of Antimicrobial Resistance, University and University Hospital of North Norway, Tromsø, Norway
- 3Dermatologic and Venereologic Dispensary of Arkhangelsk region, Arkhangelsk, Russia
- 4National Reference Laboratory for Pathogenic Neisseria, Department of Clinical Microbiology, Örebro University Hospital, Örebro, Sweden
- 5Department of Internal Medicine B, University Hospital of North Norway, University of Tromsø, Tromsø, Norway
- Correspondence to: Dr V Skogen Department of Internal Medicine B, University Hospital of North Norway, 9038 Tromsø, Norway; vegard.skogen{at}unn.no
- Accepted 30 August 2006
- Published Online First 13 September 2006
Abstract
Objectives: To characterise comprehensively the antibiotic susceptibility of Neisseria gonorrhoeae in Arkhangelsk, Russia, and to investigate whether the recommended treatment guidelines are updated and effective.
Methods: The susceptibility of N gonorrhoeae isolates, cultured during June–November 2004 mainly from consecutive patients with gonorrhoea (n = 76) in Arkhangelsk, to penicillin G, ampicillin, cefixime, ceftriaxone, ciprofloxacin, erythromycin, azithromycin, kanamycin, spectinomycin and tetracycline was analysed using Etest. Nitrocefin discs were used for β-lactamase detection.
Results: The levels of intermediate susceptibility and resistance to the different antibiotics were as follows: penicillin G 76%, ampicillin 71%, cefixime 0%, ceftriaxone 3%, ciprofloxacin 17%, erythromycin 54%, azithromycin 14%, kanamycin 49%, spectinomycin 0% and tetracycline 92%. Of the isolates 55 (72%) were determined as multiresistant—that is, they showed intermediate susceptibility or resistance to three or more classes of antibiotics. However, none of the isolates were β-lactamase producing.
Conclusions: In Arkhangelsk, and presumably in many other areas of Russia, penicillins, ciprofloxacin, erythromycin, azithromycin, kanamycin and tetracycline should not be used in the treatment of gonorrhoea if the results of antibiotic susceptibility testing are not available. In Russia, optimised, standardised and quality-assured antibiotic susceptibility testing needs to be established in many laboratories. Subsequently, continuous local, regional and national surveillance of antibiotic susceptibility is crucial to detect the emergence of new resistance, monitor changing patterns of susceptibility and be able to update treatment recommendations on a regular basis.
Footnotes
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Online first 13 September 2006
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VS designed the study and collected the gonococcal isolates in Arkhangelsk, Russia, in collaboration with NF, TA and IL; BCH, MU and VV performed the laboratory examinations of the isolates and analysis of the results; VV, MU and VS wrote the manuscript in collaboration with all the co-authors.
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Competing interests: None.
