Abstract
This study compared the abilities of ciprofloxacin and cefixime to kill intracellular Neisseria gonorrhoeae in a human fallopian tube organ culture assay. When invasion was inhibited by cytochalasin D, 0.996% of the tissue-associated gonococci survived ciprofloxacin exposure compared to 1.70% of gonococci exposed to cefixime (95% confidence interval for the ratio of the means, 0.267 to 1.30), indicating that the two antibiotics did not significantly differ in the ability to kill extracellular attached organisms. In the absence of cytochalasin D, 1.63% survived ciprofloxacin exposure while 9.76% survived cefixime treatment (95% confidence interval for the ratio of the means, 0.067 to 0.418). These results suggest that ciprofloxacin penetrated epithelial cells and killed intracellular gonococci better than did cefixime. Thus, at concentrations achievable in serum, ciprofloxacin was more effective in total gonococcal killing than cefixime in this human fallopian tube organ culture model.
Highlights
An estimated 400,000 new cases of gonorrhea occurred in 1995 in the United States [8]
The feasibility of the approach was established by applying the gentamicin-cytochalasin D invasion assay to the fallopian tube organ culture (FTOC) model for documentation of microfilament-dependent gonococcal invasion of the fallopian tube epithelium
The data represent results from one experiment. n is the number of homogenate values. b Pooled groups unexposed to antibiotics in the presence or absence of cytochalasin D. c The 95% confidence interval for the mean. d NA, not applicable
Summary
An estimated 400,000 new cases of gonorrhea occurred in 1995 in the United States [8]. McGee et al used a fallopian tube organ culture (FTOC) model to study gonococcal invasion. Four steps in the invasion process were outlined: attachment with tight adherence to nonciliated columnar epithelial cells, endocytosis into the epithelium, transcytosis through the cells, and exocytosis of the organisms into subepithelial spaces [26] This finding in the organ culture system corroborated histological observations of intracellular gonococci in fallopian tube, cervix, and urethral epithelium samples taken from patients [1, 11, 26, 38]. The relative intracellular killing of ciprofloxacin versus cefixime was tested in the FTOC model of gonococcal infection. A secondary goal of this study was to establish an invasion assay for the FTOC model based on differential killing of extracellular versus intracellular gonococci by antibiotics
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