Incidence, epidemiology and evolution of reduced susceptibility to ciprofloxacin in Neisseria gonorrhoeae in Korea

• Published in: Clinical microbiology and infection Vol. 4; no. 11; pp. 627 - 633
• Main Authors: Lee, Kyungwon, Chong, Yunsop, Erdenechemeg, L., Song, Kyung Soon, Shin, Kwang Hun
• Format: Journal Article
• Language: English
• Published: Oxford, UK Elsevier Ltd 01-11-1998; Blackwell Publishing Ltd; Blackwell; Elsevier Limited
• Subjects: Antibacterial agents; Antibiotics. Antiinfectious agents. Antiparasitic agents; Biological and medical sciences; ciprofloxacin resistance; Medical sciences; Neisseria gonorrhoeae; Pharmacology. Drug treatments; plasmid; Tropical medicine; β-lactamase; Asia; Korea; plasmid; Neisseria gonorrhoeae; β-lactamase; ciprofloxacin resistance; Drug susceptibility test; Neisseriaceae; Epidemiology; Incidence; Antibiotic; Fluoroquinolone derivatives; Bacteria; Micrococcales; Evolution; Antibacterial agent; Ciprofloxacin; Quinolone derivatives
• ISSN: 1198-743X; 1469-0691
• DOI: 10.1111/j.1469-0691.1998.tb00345.x

To verify the decrease of susceptibility to ciprofloxacin in Neisseria gonorrhoeae, determine the size of the recently reported new β-lactamase plasmid and explain the high prevalence of penicillinase-producing Neisseria gonorrhoeae (PPNG).
Gonococci were isolated from prostitutes in Korea. Antimicrobial susceptibility was tested by NCCLS disk diffusion and agar dilution methods. Plasmid was isolated by an alkaline lysis method. Patterns of NheI-digested genomic DNA were compared after pulsed-field gel electrophoresis (PFGE).
The minimum inhibitory concentration of ciprofloxacin for 50% of the isolates rose from 0.015 mg/L in 1993 to 0.12 mg/L in 1996. The proportion of PPNG remained at 70% or over during the 5-year period. The size of a novel β-lactamase plasmid, first reported in 1994, was determined to be approximately 3.2 MDa, and 48% of the PPNG isolates contained it. Twelve of 50 isolates had the same PFGE pattern and nine others another pattern.
The rapid decrease of fluoroquinolone-susceptible gonococci suggests that in the near future the drug may become less useful for gonorrhea treatment. The new 3.2-MDa plasmid may have been introduced as a result of the recent increase in overseas travel. The PFGE pattern suggests that high prevalence of PPNG may be due to dissemination of a few resistant clones among the high-risk groups.