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National Surveillance of Antimicrobial Resistance in Neisseria gonorrhoeae
Sandra K. Schwarcz, MD, MPH;
Jonathan M. Zenilman, MD;
Daniel Schnell, PhD;
Joan S. Knapp, PhD;
Edward W. Hook III, MD;
Sumner Thompson, MD, MPH;
Franklyn N. Judson, MD;
King K. Holmes, MD, PhD
JAMA. 1990;264(11):1413-1417.
Abstract
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The Gonococcal Isolate Surveillance Project is a national sentinel surveillance system to estimate levels and monitor trends of antimicrobial resistance in prospectively collected isolates of Neisseria gonorrhoeae. Of 6204 isolates evaluated from 21 clinic sites between September 1987 and December 1988, 21% met at least one of the surveillance criteria for resistance to penicillin, tetracycline, cefoxitin, or spectinomycin; 2.2% were penicillinase-producing N gonorrhoeae; 1.0% had high-level plasmid-mediated tetracycline resistance; and 16.8% of the isolates without plasmid-mediated resistance had chromosomally mediated resistance (defined as a minimum inhibitory concentration  2 µg/mL) to penicillin, tetracycline, or cefoxitin. Three isolates were resistant to spectinomycin. All isolates were susceptible to ceftriaxone. Resistant isolates were identified from all participating centers. Patient demographic and behavioral characteristics were not predictive of infections caused by resistant organisms. These results demonstrate the wide distribution of antimicrobial-resistant N gonorrhoeae and support recent changes in Centers for Disease Control therapy recommendations for gonococcal infections that no longer recommend tetracycline and penicillin as first-line therapies.
(JAMA. 1990;264:1413-1417)
Author Affiliations
The Gonococcal Isolate Surveillance Project
From the Division of Sexually Transmitted Diseases, Center for Prevention Services (Drs Schwarcz, Zenilman, and Schnell), and the Sexually Transmitted Disease Laboratory Program, Center for Infectious Diseases (Dr Knapp), Centers for Disease Control, Atlanta, Ga; Preventive Medicine and Epidemiology, Baltimore City Health Department, and the Department of Medicine, The Johns Hopkins University, Baltimore, Md (Dr Hook); the Department of Medicine, Emory University School of Medicine, Atlanta, Ga (Dr Thompson); the Division of Disease Control, Denver Public Health Department, and the University of Colorado (Dr Judson); and the Center for AIDS and Sexually Transmitted Diseases and the Department of Medicine, University of Washington, Seattle (Dr Holmes). Dr Zenilman is now with the Division of Infectious Diseases, The Johns Hopkins Hospital.
Footnotes
Reprint requests to Technical Information Services, Center for Prevention Services, Centers for Disease Control, Atlanta, GA 30333.
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