Neisseria gonorrhoeae resistente a la penincilina en la ciudad de México / Penicillin-resistance of Neisseria gonorrhoeae in México City

RESUMO

From July to December 1986, 607 adults of both sexes with urethral and cervicovaginal symptoms visited a venereal disease center in México City. Urethral mucosa and cervical canal smears were taken from 148 selected individuals from whom Neisseria gonorrhoeae had been isolated and who had not been treated with antimicrobials for at least the three previous weeks. Gonococci strains were identified by the morphological characteristics of the colonies staining by Gram's method, the oxidase test, and carbohydrate breakdown, and the penicillin-resistance of the isolated strains was determined. It was found that 26.3 per cent of the N. gonorrhoeae strains were penicillinase producing (PPNG) and 4.7 per cent had chromosome-mediated resistance (CMRNG). There was no significant difference in the distribution of PPNG strains in serogroups 1A (WI) and 1B (WII/III); however, all the CMRNG strains belonged to the 1B group and were isolated from males. Treatment with penicillin, ampicilin, and other antimicrobials was ineffective in one out of every three patients in the study group. For high-risk patients in whom this treatment is unsuccessful, such as the subjects of this study, the use of spectinomycin is recomended. To prevent an increase in penicillin-resistan strains, the authors suggest laboratory identification and monitoring of infected persons, follow-up of patients and identification of contacts