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Penicillinase producing gonococci: a spent force?

C A Ison, J Gedney, J R Harris

    Genitourinary Medicine
    |October 1, 1986
    PubMed
    Summary
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    Penicillinase-producing Neisseria gonorrhoeae (PPNG) incidence declined despite no changes in treatment or contact tracing. The 4.4 megadalton plasmid became more common in PPNG strains, correlating with increased antibiotic resistance.

    Area of Science:

    • Microbiology
    • Infectious Diseases
    • Public Health

    Background:

    • Penicillinase-producing Neisseria gonorrhoeae (PPNG) strains caused a rapid rise in gonorrhoea incidence from 1980 to 1982.
    • A subsequent decline in PPNG incidence was observed from 1983 onwards, continuing into 1985.

    Purpose of the Study:

    • To investigate the reasons behind the declining incidence of PPNG infections.
    • To analyze the genetic characteristics and antibiotic resistance patterns of circulating PPNG strains.

    Main Methods:

    • Surveillance of PPNG incidence and strain characteristics at St Mary's Hospital.
    • Plasmid analysis (4.4 and 24.5 megadalton plasmids) and auxotyping of PPNG strains.
    • Assessment of antibiotic resistance profiles, including erythromycin, tetracycline, streptomycin, and spectinomycin.

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    Main Results:

    • The decline in PPNG incidence was not attributed to penicillinase-stable antibiotics or improved contact tracing.
    • An increasing proportion of PPNG strains carried the 4.4 megadalton penicillinase plasmid, while strains with both 4.4 and 24.5 megadalton plasmids decreased.
    • PPNG strains with the 4.4 megadalton plasmid exhibited higher resistance to erythromycin, tetracycline, and streptomycin compared to those with the 3.2 megadalton plasmid. Spectinomycin resistance was exclusively found in strains with the 4.4 megadalton plasmid.

    Conclusions:

    • The shift in plasmid prevalence, particularly the rise of the 4.4 megadalton plasmid, may be linked to the observed decline in PPNG incidence.
    • The increasing prevalence of the 4.4 megadalton plasmid is associated with broader antibiotic resistance, posing a potential future public health challenge.