Penicillinase-producing Neisseria Gonorrhoeae Strains Research Articles

Epidemiology of PPNG infections in Amsterdam: analysis by auxanographic typing and plasmid characterisation.

In January 1981 the incidence of penicillinase producing Neisseria gonorrhoeae (PPNG) strains in Amsterdam had increased to 18% of all new cases of gonorrhoea. Auxanographic typing in combination with plasmid determination of 729 PPNG strains showed that in 1981 the predominant and endemic types were those with the Africa plasmid and transfer factor which were non-requiring and inhibited by phenylalanine. In 1982 proline requiring strains with the Asia plasmid and transfer factor increased after being imported and spread by prostitution. Four different plasmid patterns and 12 auxotypes were distinguishable. Unusual auxotypes of both African and Asian plasmid types are frequently imported, some disappearing soon after their introduction into Holland but others providing an opportunity to trace sources and contacts. Prostitution and the biological properties of PPNG strains seem to play an important role in their spread. Only 2.6% of them were isolated from homosexual men. In areas where PPNG strains are prevalent, auxotyping is an important tool in their surveillance.

Penicillinase-producing Neisseria gonorrhoeae isolates from different localities in south east Asia. Susceptibility to 15 antibiotics.

Sixty four penicillinase-producing Neisseria gonorrhoeae (PPNG) and 24 non-penicillinase-producing (non-PPNG) strains isolated from six different south east Asian localities were tested by the agar dilution method against 15 antibiotics. All isolates were susceptible to spectinomycin and sulphamethoxazole-trimethoprim (19:1 ratio). A large proportion of both PPNG and non-PPNG strains showed, however, a decreased susceptibility to tetracycline, kanamycin, and erythromycin: 49% with minimum inhibitory concentrations (MICs) of tetracycline greater than or equal to 2 micrograms/ml, 34% with MICs of kanamycin greater than or equal to 32 micrograms/ml, and 80% with MICs of erythromycin greater than or equal to 2 micrograms/ml. These MIC cut-off values were chosen since they are close to the highest concentrations of these antibiotics attainable in serum after drug administration. Resistance to these antibiotics was not related to penicillinase production and does not appear to be confined to gonococci isolated from one particular locality. Strains showing resistance concurrently to two or three of these drugs were often isolated from different south east Asian countries. All eight cephalosporins tested were effective against both PPNG and non-PPNG strains. On a weight to weight basis the new cephalosporins--namely, moxalactam, cefoperazone, cefotaxime, and ceftriaxone--were the most effective. In contrast to those of cefoxitin, cefuroxime, moxalactam, and cefoperazone the MICs of cefamandole, cefotaxime, and ceftriaxone were significantly affected when the inoculum size was increased from 10(3) to 10(6) colony forming units (cfu).

Penicillinase-producing Neisseria gonorrhoeae among prostitutes in Surabaya.

Thirty-six strains of penicillinase-producing Neisseria gonorrhoeae (PPNG) were detected among 794 prostitutes between October 1981 and May 1982 in Surabaya, Indonesia. The high prevalence of PPNG strains among the high-class prostitutes and a lower prevalence among the low-class suggest that regular mass treatment for syphilis did not play an important role in the emergence and spread of PPNG; the importation of PPNG strains from abroad is more likely to have been responsible.

Antibiotic sensitivity patterns of penicillinase-positive and penicillinase-negative strains of Neisseria gonorrhoeae isolated in Fukuoka, Japan.

Penicillinase production and minimum inhibitory concentrations (MICs) of penicillin G, amoxycillin, doxycycline, and spectinomycin were studied for 155 gonococcal strains isolated in Fukuoka, Japan, between April and December 1981. Of 155 isolates, 25 (16.1%) strains were identified as penicillinase-producing Neisseria gonorrhoeae (PPNG) by a rapid iodometric test. The antibiotic sensitivity of 130 penicillinase-negative (non-PPNG) and 25 PPNG strains was compared. The mean MIC of penicillin G for non-PPNG strains was 0.65 microgram/ml. Twenty-five PPNG strains had MICs of penicillin G between 6.25 and greater than 100 micrograms/ml. The susceptibility to amoxycillin and doxycycline of PPNG strains was significantly lower than that of non-PPNG strains. All the strains proved to be sensitive to spectinomycin. The MICs of four antibiotics for non-PPNG strains were significantly correlated.

Penicillinase-producing Neisseria gonorrhoeae ophthalmia neonatorum in Singapore.

The problem of ophthalmia neonatorum due to penicillinase-producing Neisseria gonorrhoeae (PPNG) has grown with the increasing prevalence of PPNG strains in Singapore. The epidemiological trends, clinical features, and treatment of ophthalmia neonatorum due to PPNG have been determined from the case histories of 11 babies with this condition treated between 1978 and 1980. All 11 cases were cured with a single intramuscular injection of kanamycin 0.5 g and 1% kanamycin eyedrops instilled for three days. In six of the 11 mothers, a non-PPNG strain was isolated.

Molecular and phenotypic characterization of penicillinase-producing Neisseria gonorrhoeae from Canadian sources.

The incidence of penicillinase-producing Neisseria gonorrhoeae (PPNG) infections has increased in Canada during the past 2 years. Most of these cases were imported from abroad. The PPNG strains from these cases were characterized with respect to susceptibility to 11 antibiotics, auxotype, and plasmid content. Rosaramicin and cefuroxime proved to be the most potent of the antibiotics tested. The molecular characterization of the isolates indicated that all carried a 2.6-megadalton cryptic plasmid. Most of the PPNG isolates (87%) harbored a 4.5-megadalton penicillinase-producing plasmid, whereas only 13% harbored the 3.2-megadalton penicillinase-producing plasmid. In those cases where contact tracing was possible, the correlation linking strains of Far Eastern etiology with carriage of the 4.5-megadalton plasmid was upheld. The penicillinase-producing strains were typed auxanographically in either the proline-requiring (57%) or prototrophic groups (42%). Substrate hydrolysis profiles and analytical isoelectric focusing of crude beta-lactamase extracts of several isolates has reconfirmed that these strains elaborate a type TEM-1 enzyme. Several of the penicillinase-producing plasmids were also examined for plasmid stability.

Epidemiology of penicillinase-producing Neisseria gonorrhoeae in Singapore.

The number of infections with penicillinase-producing Neisseria gonorrhoeae (PPNG) strains in Singapore has risen from three in 1976 to 1792 in 1979. In the latter year they formed 19.2% of all infections with gonorrhoea, and 1280 of the strains isolated were from female prostitutes. The prevalence of PPNG infections is analysed according to the different sections of the community and racial groups. Despite energetic control measures PPNG strains are not being contained within Singapore. Thus global dissemination from such a busy port and tourist centre is a real danger.

Gentamicin in the treatment of infections due to penicillinase-producing gonococci.

Ninety-seven patients with infections due to penicillinase-producing Neisseria gonorrhoeae (PPNG) were treated with single doses of gentamicin 280 mg intramuscularly. The failure rate among those followed up was 3%. No significant side effects were recorded. Gentamicin is a valuable alternative in the treatment of infections due to PPNG strains.

Penicillinase-producing Neisseria gonorrhoeae in the Netherlands: epidemiology and genetic and molecular characterization of their plasmids.

Penicillinase-producing Neisseria gonorrhoeae strains were isolated in the Netherlands with increasing frequency during the period of 1976 to 1979. About 3% of the gonococci isolated in the first half of 1979 produced penicillinase. In contrast to the period of 1976 to 1977, most penicillinase-producing N. gonorrhoeae infections during the period of 1978 to 1979 were contracted in the Netherlands. The results of genetic and molecular studies on 80 penicillinase-producing N. gonorrhoeae strains were similar to earlier observations of others: resistance plasmids of only two sizes, 4.5 and 3.3 megadaltons (Md), occurred in penicillinase-producing N. gonorrhoeae strains, and these encoded for the TEM-1 enzyme. The 4.5-Md plasmid could be transferred to Escherichia coli when it coexisted with a plasmid of 24 Md. The latter plasmid was present in the vast majority of the strains carrying the 4.5-Md plasmid. One strain carried a cryptic 7.5-Md plasmid in addition to the commonly found 2.5-Md plasmid. Two penicillinase-producing strains of Haemophilus parainfluenzae isolated were found to carry a 3.3-Md plasmid species which was indistinguishable from the 3.3-Md gonococcal resistance plasmids. No plasmid deoxyribonucleic acid was found in two strains of penicillinase-producing Branhamella catarrhalis, and these strains produced a penicillinase different from the TEM-1 enzyme.

Gonorrhea in Rotterdam caused by penicillinase-producing gonococci.

Recently the prevalence of strains of penicillinase-producing Neisseria gonorrhoeae (PPNG) in the Netherlands has increased. A study of demographic and clinical data from patients with gonorrhoea due to PPNG strains, and of the biological characteristics of the strains isolated in Rotterdam, show that Asian strains of PPNG seem at present to be endemic in the Netherlands. Spectinomycin was found to be effective in the treatment of patients with gonorrhoeea due to PPNG strains.