Particular features of clinical manifestations of the gonococcal infection and tactics for treating the disease in view of the antibiotic sensitivity of N. gonorrhoeae in the Arkhangelsk region

Abstract

Goal of the study. To examine clinical manifestations of the gonococcal infection and determine the tactics for treating the disease in view of the antibiotic sensitivity of N. gonorrhoeae strains obtained from patients suffering from the gonococcal infection in the Arkhangelsk region. Study materials. Patients suffering from the gonococcal infection (14,502 male and 4,135 female patients); 254 N. gonorrhoeae strains obtained from patients suffering from the gonococcal infection in the Arkhangelsk region in 2006-2013. Study methods: examination of the case history, clinical, instrumental (ultrasound examination) and laboratory (microscopy, bacteriological). The sensitivity of N. gonorrhoeae to antimicrobial drugs (penicillin, tetracycline, ciprofloxacin, spectinomycin, azithromycin and ceftriaxone) was studied by the agar serial dilution method. Key findings. Non-complicated forms of the disease prevailed in patients suffering from the gonococcal infection who consulted medical dermatovenereology institutions in the Arkhangelsk region for examination and treatment (98.3%), and the course of the inflammatory process was asymptomatic (10.3%) or with few symptoms (55.8%). A high level of N. gonorrhoeae resistance to penicillin, tetracycline, ciprofloxacin, spectinomycin and azithromycin was revealed in 2006-2011. The exclusion of these drugs from the treatment regimens for the gonococcal infection made it possible to substantially reduce the resistance level in 2013. Ceftriaxone was the only drug for the treatment of the gonococcal infection that remained efficient for the treatment of all N. gonorrhoeae strains during the study period. Conclusion. A complex of measures to prevent the propagation of the gonococcal infection in the Arkhangelsk region must include screenings of risk groups with regard to the infection and propagation of the disease regardless of the presence of clinical symptoms of the inflammatory process, introduction of high-sensitivity and specific molecular and biological diagnostics methods, and administration of an anti-gonococcal therapy in view of the antibiotic resistance of N. gonorrhoeae strains obtained from patients in the region.