We aim to monitor the trends of antimicrobial resistance in Neisseria gonorrhoeae and to compare the results of antimicrobial sensitivity by disc diffusion and minimum inhibitory concentration (MIC). Two hundred and eleven confirmed strains of N. gonorrhoeae were subjected to antimicrobial sensitivity testing by disc diffusion using penicillin, tetracycline, ciprofloxacin and ceftriaxone from 1995 to June 1999. Penicillinase-producing Neisseria gonorrhoeae (PPNG) were detected by lodometric method. Minimum inhibitory concentration was determined by E test. A low level of penicillin resistance and PPNG detected in 1996 was maintained over the years. Significant increasing trend of tetracycline and ciprofloxacin resistance with high MIC i.e. 2-96 microg/ml and 1-32 microg/ml respectively were found. Ceftriaxone was found to be the drug of choice, being 100% sensitive. Comparison of resistance pattern by the 2 tests showed satisfactory agreement. Emergence of penicillin, quinolone and tetracyline resistance in N. gonorrhoeae isolates from a major STD centre at New Delhi indicates the need for increased awareness, prudent use of antimicrobials, and evaluation of new antimicrobials for the treatment of gonorrhoea.
PIP: This study determined the prevalence of antimicrobial resistance by Neisseria gonorrhoeae, including penicillinase-producing gonorrhea (PPNG) strains, and monitored the trends. It further compared the results of antimicrobial sensitivity by disc diffusion and minimum inhibitory concentration (MIC). A total of 211 confirmed gonorrhea strains were subjected to antimicrobial sensitivity testing by disc diffusion using penicillin, tetracycline, ciprofloxacin, and ceftriaxone from 1995 to June 1999. PPNG strains were detected by lodometric method, and an E test method of 55 strains isolated in 1997-98 determined MIC. Statistical analysis of the results indicates that a low level of penicillin resistance and PPNG detected in 1996 was maintained over the years. In addition, a significant increasing trend of tetracycline and ciprofloxacin resistance with high MIC was found. Ceftriaxone, being 100% sensitive, was found to be the drug of choice. Moreover, comparison of resistance pattern by the two tests showed satisfactory agreement. Findings indicate the need for increased awareness, prudent use of antimicrobials, and evaluation of new antimicrobials for the treatment of gonorrhea.