%0 Journal Article
%T Increasing Trend of Resistance to Penicillin, Tetracycline, and Fluoroquinolone Resistance in Neisseria gonorrhoeae from Pakistan (1992每2009)
%A Kauser Jabeen
%A Summiya Nizamuddin
%A Seema Irfan
%A Erum Khan
%A Faisal Malik
%A Afia Zafar
%J Journal of Tropical Medicine
%D 2011
%I Hindawi Publishing Corporation
%R 10.1155/2011/960501
%X Emergence and spread of drug resistant Neisseria gonorrhoeae is global concern. We evaluated trends of antimicrobial resistance in Neisseria gonorrhoeae over years 1992每2009 in Pakistan. Resistance rates were compared between years (2007每2009) and (1992每2006). Antimicrobial susceptibility testing was performed and interpreted according to Clinical Laboratory Standards Institute (CLSI) criteria using the disk diffusion methodology against penicillin, ceftriaxone, tetracycline and ofloxacin. Additional antibiotics tested in 100 strains isolated during 2007每2009, included cefotaxime, cefoxitin, cefuroxime, cefipime, ceftazidime, ceftizoxime, cefixime, cefpodoxime, spectinomycin and azithromycin. Neisseria gonorrhoeae ATCC 49226 was used as control. Chi-square for trend analysis was conducted to assess resistance trend over the study period. During study period significant increase in combined resistance to penicillin, tetracycline and ofloxacin was observed (P value ). Resistance rates during the two study period also increased significantly (P value ). Ceftriaxone resistance was not observed. None of the isolates were found to be resistant or with intermediate sensitivity to additional antibiotics. Our findings suggest that penicillin, ciprofloxacin, tetracycline should not be used in the empirical treatment of gonorrhea in Pakistan. Ceftriaxone and cefixime should be the first line therapy; however periodic MICs should be determined to identify emergence of strains with reduced susceptibility. 1. Introduction Gonorrhea continues to be a public health problem with the emergence of multidrug resistant strains [1]. Accurate diagnosis with effective treatment to prevent further transmission is one of the essential elements for control of gonococcal infections [2]. Treatment strategies should be devised to utilize appropriate and preferably single-dose therapy that could be conveniently administered at the time of diagnosis [3]. Surveillance of Neisseria gonorrhoeae antimicrobial resistance is crucial in guiding empirical therapy in any individual setting as resistance may vary in different countries [4]. Neisseria gonorrhoeae infections have been reported from Pakistan as a cause of sexually transmitted infections, but unfortunately national surveillance data is not available to assess its prevalence or antimicrobial resistance [5, 6]. Due to limited resources and lack of trained technologist and microbiologists, most of the laboratories do not report Neisseria gonorrhoeae. Therefore, existing antimicrobial resistance data from the country is limited and
%U http://www.hindawi.com/journals/jtm/2011/960501/