Introduction

The incidence and prevalence of gonorrhoea in Mongolia appear to be high and increasing.¹ Progress towards control of gonorrhoea requires the availability of effective antibiotic treatment. However, the susceptibility of Neisseria gonorrhoeae isolated in Mongolia is difficult to ascertain. A brief report some years ago noted “substantial” resistance to penicillins and quinolones and, surprisingly, third generation cephalosporins.²

Other factors decrease antibiotic availability. Some efficacious antibiotics recommended for treatment of gonorrhoea in developed countries are too expensive in Mongolia¹ so that tetracyclines, gentamicin, and quinolones are most often used. Antibiotics are also freely available from pharmacies in Mongolia, and treatments obtained from these sources may be multidose and uncontrolled. There is thus the potential for the development of further antibiotic resistance.

The susceptibility of gonococcal isolates from Ulaanbaatar to a number of antibiotics recommended for treatment in WHO standard guidelines and the in vitro susceptibility of gonococci to gentamicin, an aminoglycoside antibiotic currently used in Mongolia, is reported. Analysis of patterns of antibiotic resistance was enhanced by phenotyping gonococcal isolates.

Materials and methods

Fifty six unselected isolates from symptomatic patients (26 males and 30 females) attending the central STD clinic in Ulaanbaatar were identified by standard procedures. The minimum inhibitory concentration (MIC) and categorisation of the susceptibility of the isolates to penicillin, ciprofloxacin, spectinomycin, and ceftriaxone were determined by the standardised techniques.³ …