Abstract

Objectives: To investigate comprehensively the antimicrobial susceptibility and resistance of N gonorrhoeae during 2005-2006 in a national survey and to recommend effective antimicrobials for treatment of gonorrhoea in Russia.

Methods: The susceptibility of N gonorrhoeae isolates, cultured mainly from consecutive gonorrhoea patients (n=1030) during the period January 2005 to December 2006 in Russia, to penicillin G, ceftriaxone, ciprofloxacin, tetracycline, and spectinomycin was analysed using agar dilution method. Nitrocefin discs were used for β-lactamase detection.

Results: All isolates were susceptible to ceftriaxone. However, during 2005 and 2006 in total 5%, 48%, 70%, and 77% displayed intermediate susceptibility or resistance to spectinomycin, ciprofloxacin, tetracycline and penicillin G, respectively. Furthermore, in total 4% of the isolates were β-lactamase producing during these years. The different federal districts (FDs) of Russia displayed substantial heterogeneities in regards of prevalence of gonorrhoea and antimicrobial resistance among the N gonorrhoeae isolates.

Conclusions: In Russia, penicillins, ciprofloxacin, or tetracycline should definitively not be used in empirical treatment of gonorrhoea. The recommended first-line antimicrobial should be ceftriaxone. If not access to ceftriaxone, spectinomycin ought to be used. However, increasing levels of intermediate susceptibility and resistance to spectinomycin have been observed during recent years and, accordingly, great care and monitoring should be undertaken when using spectinomycin. Continuous local, national and international surveillance of N gonorrhoeae antimicrobial susceptibility, in order to timely reveal emergence of new resistance, to monitor changing patterns of susceptibility, and to be able to update treatment recommendations on a regular basis, is crucial.