J M Ehret1, L J Nims, F N Judson. 1. Denver Public Health Department, University of Colorado Health Sciences Center, USA.
Abstract
BACKGROUND AND OBJECTIVES: Erythromycin is a recommended treatment for penicillin-allergic pregnant women with gonorrhea, and azithromycin has been suggested as therapy for coexisting gonococcal and chlamydial infections. Although gonococcal resistance to erythromycin is not uncommon, decreased resistance to azithromycin is rare. A clinical isolate of Neisseria gonorrhoeae with in vitro resistance to erythromycin and decreased susceptibility to azithromycin is reported. STUDY DESIGN: This is a case report. RESULTS: Antimicrobial susceptibility testing of a clinical isolate of N. gonorrhoeae revealed a minimal inhibitory concentration (MIC) of 2 micrograms/ml to azithromycin and 32 micrograms/ml to erythromycin. Five hundred other urethral isolates were tested, resulting in an MIC for erythromycin ranging from 0.015 to 2 micrograms/ml. The range for azithromycin was 0.015 to 0.5 micrograms/ml. There was a strong correlation between erythromycin and azithromycin MICs (r = 0.73; P < 0.0001). CONCLUSIONS: Continued national monitoring is needed to detect the appearance and early dissemination of new types of gonococcal resistance.
BACKGROUND AND OBJECTIVES:Erythromycin is a recommended treatment for penicillin-allergic pregnant women with gonorrhea, and azithromycin has been suggested as therapy for coexisting gonococcal and chlamydial infections. Although gonococcal resistance to erythromycin is not uncommon, decreased resistance to azithromycin is rare. A clinical isolate of Neisseria gonorrhoeae with in vitro resistance to erythromycin and decreased susceptibility to azithromycin is reported. STUDY DESIGN: This is a case report. RESULTS: Antimicrobial susceptibility testing of a clinical isolate of N. gonorrhoeae revealed a minimal inhibitory concentration (MIC) of 2 micrograms/ml to azithromycin and 32 micrograms/ml to erythromycin. Five hundred other urethral isolates were tested, resulting in an MIC for erythromycin ranging from 0.015 to 2 micrograms/ml. The range for azithromycin was 0.015 to 0.5 micrograms/ml. There was a strong correlation between erythromycin and azithromycin MICs (r = 0.73; P < 0.0001). CONCLUSIONS: Continued national monitoring is needed to detect the appearance and early dissemination of new types of gonococcal resistance.
Authors: Pam Sawatzky; Gary Liu; Jo-Anne R Dillon; Vanessa Allen; Brigitte Lefebvre; Linda Hoang; Greg Tyrrell; Paul Van Caeseele; Paul Levett; Irene Martin Journal: J Clin Microbiol Date: 2015-09-02 Impact factor: 5.948
Authors: Supriya D Mehta; Ian Maclean; Jeckoniah O Ndinya-Achola; Stephen Moses; Irene Martin; Allan Ronald; Lawrence Agunda; Ruth Murugu; Robert C Bailey; Johan Melendez; Jonathan M Zenilman Journal: Antimicrob Agents Chemother Date: 2011-05-23 Impact factor: 5.191
Authors: Walter Demczuk; Tarah Lynch; Irene Martin; Gary Van Domselaar; Morag Graham; Amrita Bharat; Vanessa Allen; Linda Hoang; Brigitte Lefebvre; Greg Tyrrell; Greg Horsman; David Haldane; Richard Garceau; John Wylie; Tom Wong; Michael R Mulvey Journal: J Clin Microbiol Date: 2014-11-05 Impact factor: 5.948
Authors: Kaede V Ota; Frances Jamieson; David N Fisman; Karen E Jones; Itamar E Tamari; Lai-King Ng; Lynn Towns; Prasad Rawte; Alessandro Di Prima; Tom Wong; Susan E Richardson Journal: CMAJ Date: 2009-02-03 Impact factor: 8.262
Authors: M C Roberts; W O Chung; D Roe; M Xia; C Marquez; G Borthagaray; W L Whittington; K K Holmes Journal: Antimicrob Agents Chemother Date: 1999-06 Impact factor: 5.191
Authors: I Martin; P Sawatzky; V Allen; B Lefebvre; Lmn Hoang; P Naidu; J Minion; P Van Caeseele; D Haldane; R R Gad; G Zahariadis; A Corriveau; G German; K Tomas; M R Mulvey Journal: Can Commun Dis Rep Date: 2019-02-07