Incidence of beta lactamase-producing Neisseria gonorrhoeae in a select population

Abstract

THE RECENT ISOLATION of beta lactamaseproducing strains of Neisseria gonorrhoeae1-3 has produced well-founded concerns that these organisms might soon result in a serious public health problem in the United States. Soon after the appearance of the initial isolate’ at Travis Air Force Base, California, it became clear that military persons were bringing strains of this penicillin G-resistant organism to this country from Asia. Travis Air Force Base is a major debarkation point for military persons returning from Asian tours of duty. Therefore, these concerns prompted institution of a David Grant Medical Center (DGMC) gonococcal surveillance program to answer questions which included: Has the resistant organism become disseminated in our population? Are these strains more virulent than previously known strains? Are the symptomatic carrier rates similar to those observed with common strains of Nrisseria gonorrhoeae? Endocervical and, in some cases, rectal cultures were obtained randomly from women (women on active duty in the military or dependents of active-duty military persons) 15 through 35 years old and receiving care in the DGMC Obstetrics and Gynecology Clinics. In each case the alginate culture swabs were immediately applied into Thayer-Martin media* and placed within minutes in incubators. Appropriate cultures were also obtained from all persons seen in DGMC Clinics with signs and symptoms consistent with a diagnosis of gonorrhea or known contact with persons known to have gonorrhea. Swabs were plated on Thayer-Martin media and incubated at 37” C. in 5 per cent carbon dioxide media. Plates were read at 24 and 48 hours. All suspicious colonies were tested for Gram stain morphology,