Background The increasing antimicrobial resistance in N. gonorrhoeae threatens the effectiveness of single-dose treatment compromising the control of the infection.

Recent reports of third generation cepahalosporins and azithromycin resistance coupled with the already described frequent ciprofloxacin resistance makes it mandatory to monitor the local susceptibility patterns.

Methods Susceptibility by agar dilution technique to ciprofloxacin, azythromycin, ceftriaxone, penicillin and tetracycline was performed to 59 and 56 isolates received in 2010 and 2011 respectively. GASP - LAC MIC interpretative criteria standards were used. Betalactamase production was detected by chromogenic cephalosporin method.

Results In 2011 CIM 90 shifted for ciprofloxacin (8-fold), azithromycin (4-fold) and ceftriaxone (2-fold). The rates of resistant isolates reached 28% and 10% for ciprofloxacin and azithromycin respectively. All the isolates tested were susceptible to ceftriaxone.

Isolates showing resistance to one drug frequently shared resistance or decreased susceptibility to other antibiotics.

One isolate showed decreased susceptibility to ceftriaxone (CIM 0.125 μg/mL) and ciprofloxacin (CIM 0.5 μg/mL), resistance to azythromycin (CIM 2 μg/mL) and is a TRNG.

Conclusions In 2011 an overall increase in either resistance, decreased susceptibility and multidrug resistance was observed. These observed increasing antimicrobial resistance and multidrug resistance to first line treatment antibiotics is worrisome and reinforces the need of continuous surveillance.