Penicillinase-producing gonococcal strains in Zambia. Observations on treatment failures.

A V Ratnam,M I Patel,R C Mulenga,S K Hira

doi:10.1136/sti.58.1.29

Abstract

Penicillinase-producing strains of Neisseria gonorrhoeae (PPNG) were detected in nine out of 27 (3.2%) treatment failures in 310 cases of acute gonococcal urethritis in men in Lusaka, Zambia. Minimum inhibitory concentrations of penicillin for 17.2% of 233 gonococcal isolates were less than or equal to 0.05 microgram/ml, for 38.2% between 0.125 and 0.25 microgram/ml, and for 46.6% greater than or equal to 0.5 microgram/ml. At present the prevalence of PPNG in African countries is not known but is likely to increase rapidly unless simplified control schemes are adopted within the existing health care programmes. Endemic pockets of PPNG in a few countries can threaten worldwide efforts to control gonorrhoea.

Highlights

Penicillin is still the drug of choice for the treatment of gonorrhoea, continued surveillance of the susceptibility of gonococci to penicillin has become mandatory because of increasing drug resistance
It has been observed that penicillinase-producing Neisseria gonorrhoeae (PPNG) survive high doses of various penicillins but are less susceptible to many other antibiotics.[23]
Reports from many countries[4,5,6,7] indicate a higher prevalence of gonorrhoea in Africa than elsewhere and that gonococcal strains which are less susceptible to penicillin are more prevalent.Y-'2

Summary

Introduction

Penicillin is still the drug of choice for the treatment of gonorrhoea, continued surveillance of the susceptibility of gonococci to penicillin has become mandatory because of increasing drug resistance. It has been observed that PPNG survive high doses of various penicillins but are less susceptible to many other antibiotics.[23]. Reports from many countries[4,5,6,7] indicate a higher prevalence of gonorrhoea in Africa than elsewhere and that gonococcal strains which are less susceptible to penicillin are more prevalent.Y-'2. High incidences of gonorrhoea have been reported among patients attending the sexually transmitted diseases clinic in Lusaka, 3 in pregnant women,[14] and in patients with pelvic inflammatory disease.'[5]. Accepted for publication 24 July 1981 gonococcal strains and the clinical and laboratory aspects of 27 cases of treatment failure

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Discussion

Conclusion