Prevalence of penicillinase-producing Neisseria gonorrheae in Korea

An almost two-fold increase in the monthly reported case rate for sexually transmitted disease (STD) in U.S. military members assigned in the Republic of Korea in April 1981 prompted an epidemiologic assessment of that population. Inasmuch as previously nonexistent treatment failures for Neisseria gonorrheae were also being reported, a demographic slice of 253 symptomatic military members was surveyed in June and July, 1981, for gonorrhea prevalence and the proportion of this that could be attributed to penicillinase-producing Neisseria gonorrheae (PPNG). Using standard and accepted methods, the gonorrhea prevalence rate in symptomatic military members was found to be 100% while the proportion that could be attributed to PPNG was 43%. In order to compare this to the contact population of local prostitutes, 116 asymptomatic women who presented to local STD clinics for routine, often legally-mandated examinations, were surveyed. The expected lower gonorrhea prevalence rate was 13.9% but the proportion attributed to PPNG was 27.6%. This data was similar to the sudden increase in PPNG experienced by U.S. military forces at Subic Bay in the Philippines in 1979 and reflected the slow but steady migration of this resistance throughout Asia. The long-accepted norm for gonorrhea treatment using penicillin was changed to spectinomycin in the U.S. military population and was being considered for implementation by the Korean official health community. Further organism resistance can be expected, and close monitoring is taking place.