Penicillinase-producing Neisseria gonorrhoeae: results of surveillance in the United States.

In September 1976 the Center for Disease Control (Atlanta, Georgia) initiated surveillance for cases of infection due to penicillinase-productin Neisseria gonorrhoeae in the United States. One hundred ninety-one cases of penicillinase-producing gonococcal infection were confirmed through June 30, 1977. Of 177 cases for which histories of sexual exposure were available, 69 were traced to sexual contact in the Far East, and one was traced to sexual contact in West Africa. Of 181 cases for which clinical information was available, 174 were uncomplicated anogenital infections, but local complications, such as salpingitis, epididymitis, and a Bartholin's gland abscess, were reported. Spectinomycin is the only drug now recommended by the U.S. Public Health Service for treatment of gonorrhea that is effective against uncomplicated infections due to penicillinase-producing gonococci. For these organisms, the distribution of minimal inhibitory concentrations (MICs) of penicillin, ampicillin, tetracycline, erythromycin, and spectinomycin was higher than and significantly different from the distribution of MICs for isolates of non-penicillinase-producing gonococci collected in this country. Since surveillance began the incidence of confirmed cases of penicillinase-producing gonococcal infection has decreased from 20.8 cases per month in 1976 to 16.8 cases per month in 1977.