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dc.contributor.authorMehta, Supriya D.
dc.contributor.authorMaclean, Ian
dc.contributor.authorNdinya-Achola, Jeckoniah O.
dc.contributor.authorMoses, Stephen
dc.contributor.authorMartin, Irene
dc.contributor.authorRonald, Ronald,
dc.contributor.authorAgunda, Lawrence
dc.contributor.authorMurugu, Ruth
dc.contributor.authorBailey, Robert C.
dc.contributor.authorMelendez, Johan
dc.contributor.authorZenilman, Jonathan M.
dc.date.accessioned2012-04-30
dc.date.available2012-04-30
dc.date.issued2011
dc.identifier.bibliographicCitationMehta, S. D., Maclean, I., Ndinya-Achola, J. O., Moses, S., Martin, I., Ronald, A., Agunda, L., Murugu, R., Bailey, R. C., Melendez, J., & Zenilman, J. M. 2011. Emergence of Quinolone-Resistance and Cephalosporin MIC Creep in Neisseria gonorrhoeae in a Cohort of Young Men in Kisumu, Kenya: 2. Antimicrob. Agents Chemother. 2011, 55(8):3882. DOI: 10.1128/AAC.00155-11en
dc.identifier.issn0066-4804
dc.identifier.otherDOI: 10.1128/AAC.00155-11
dc.identifier.urihttp://hdl.handle.net/10027/8292
dc.descriptionPost print version of article may differ from published version. The definitive version is available through American Society for Microbiology at DOI: 10.1128/AAC.00155-11en
dc.description.abstractIntroduction: We evaluated antimicrobial resistance in Neisseria gonorrhoeae (NG) isolated from men enrolled in a randomized trial of male circumcision to prevent HIV. Methods: Urethral specimens from men with discharge were cultured for NG. Minimum inhibitory concentrations (MICs) were determined by agar dilution. Clinical Laboratory Standards Institute criteria defined resistance: MIC≥2.0 μg/ml for penicillin, tetracycline, and azithromycin; ciprofloxacin MIC≥1.0 μg/ml; spectinomycin MIC≥128.0 μg/ml. Susceptibility to ceftriaxone and cefixime was MIC<0.25 μg/ml. Additionally, PCR amplification identified mutations in parC and gyrA genes in selected isolates. Results: From 2002–2009, 168 NG isolates were obtained from 142 men. Plasmid mediated penicillin resistance was found in 65%, plasmid mediated tetracycline resistance in 97%, and 11% were ciprofloxacin resistant (QRNG). QRNG appeared November 2007, increasing from 9.5% in 2007 to 50% in 2009. Resistance was not detected for spectinomycin, cefixime, ceftriaxone, and azithromycin, but MICs of cefixime (p=0.018), ceftriaxone (p<0.001), and azithromycin (p=0.097) increased over time. In a random sample of 51 men gentamicin MIC was: 4 μg/ml (n=1), 8 μg/ml (n=49), 16 μg/ml (n=1). Discussion: QRNG increased rapidly and alternative regimens are required for NG treatment in this area. Amid emerging multi-drug resistant NG, antimicrobial resistance surveillance is essential for effective drug choice. High levels of plasmid mediated resistance and increasing MIC for cephalosporins suggest that selective pressure from antibiotic use is a strong driver of resistance emergence.en
dc.language.isoen_USen
dc.publisherAmerican Society for Microbiologyen
dc.titleEmergence of Quinolone-Resistance and Cephalosporin MIC Creep in Neisseria 2 gonorrhoeae in a Cohort of Young Men in Kisumu, Kenya: 2002 – 2009en
dc.typeArticleen


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