Article,
A community-based outbreak of infection with penicillin-resistant Neisseria gonorrhoeae not producing penicillinase (chromosomally mediated resistance)
The New England Journal of Medicine, 313 (10): 607--611 (September 1985)PMID: 3160949.
Abstract
From February through November of 1983, 199 cases of penicillin-resistant Neisseria gonorrhoeae infection were identified in a localized epidemic in Durham, North Carolina. The isolates did not produce beta-lactamase but were unusually resistant to penicillin (minimum inhibitory concentration, 2.0 to 4.0 micrograms per milliliter), and 15 of 16 patients treated with 4.8 million units of penicillin G procaine plus 1.0 g of probenecid did not respond to therapy. Recognition of the outbreak was impeded by a lack of routine surveillance for resistance other than that mediated by beta-lactamase. All epidemic isolates had a single serotype, auxotype, and antibiotic-susceptibility profile. The outbreak was halted by changing the treatment for all patients and their contacts to spectinomycin, and by intensive epidemiologic case-finding efforts. The emergence of such resistant strains poses potential major public health problems and indicates a need for reassessment of current surveillance procedures.
Tags
- adult,
- aged,
- bacterial,
- carolina,
- chromosomes,
- disease
- epidemiologic
- female,
- g,
- gonorrhea,
- gonorrhoeae,
- humans,
- male,
- methods,
- middle
- neisseria
- north
- outbreaks,
- penicillin
- penicillinase,
- probenecid,
- procaine,
- resistance,
- spectinomycin
- {beta-lactamases,}
