Outbreak of penicillinase-producing Neisseria gonorrhoeae with an African connection

Previous outbreaks of penicillinase-producing gonococcal infection in the United States have generally been attributed to importation of Southeast Asian strains. During July 1982 through July 1983, 110 cases of gonorrhea caused by penicillinase-producing strains were reported in metropolitan Atlanta, Georgia. Among the 53 infected women, 14 (26%) had pelvic inflammatory disease (PID). Compared to other infected women, those with PID experienced a greater delay from the time of last sexual exposure (19.1 vs 8.1 days) to receipt of appropriate antibiotic therapy (P less than .01). At least 22 prostitutes were involved in the outbreak. Sixteen (76%) of 21 isolates tested were serogroup 1A; 15 required arginine and proline for growth; and 17 (81%) possessed a 3.2 megadalton plasmid. Our data suggest that this outbreak was associated with both African and Southeast Asian strains.